Larsen, Bryan R.
Larsen, Bryan R. is an individual health care provider with primary practice located at 630 E 1400 N Suite 100B, Logan UT 84341-2534. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Larsen, Bryan R. can be contacted via phone (435) 787-0270.Contact Information
Primary practice address
630 E 1400 N Suite 100B
Logan UT 84341-2534
Phone: (435) 787-0270
Fax: (435) 787-0262
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 174573-1205 | Utah |
Profile Details
| NPI number | 1972561165 |
|---|---|
| LBN Legal business name | Larsen, Bryan R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Sep 27th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972561165 | NPPES |
| Idaho | MEDICAID | 003794300 |
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