Larsen, Douglas C

Larsen, Douglas C is an individual health care provider with primary practice located at 11704 W Center Rd Suite 211, Omaha NE 68144-4375. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Larsen, Douglas C can be contacted via phone (402) 393-7050.

Contact Information

Primary practice address
11704 W Center Rd Suite 211 Omaha NE 68144-4375
Phone: (402) 393-7050
Fax: (402) 393-2814
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 689 Nebraska

Profile Details

NPI number 1053386631
LBN Legal business name Larsen, Douglas C
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Jun 15th, 2016 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053386631 NPPES
Nebraska MEDICAID 47077821700

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