Larsen, Steven Allen
Larsen, Steven Allen is an individual health care provider with primary practice located at 777 Hospital Way Bldg B, Pocatello ID 83201-5175. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Larsen, Steven Allen can be contacted via phone (208) 239-1000.Contact Information
Primary practice address
777 Hospital Way Bldg B
Pocatello ID 83201-5175
Phone: (208) 239-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | M-9927 | Idaho |
Profile Details
| NPI number | 1508953555 |
|---|---|
| LBN Legal business name | Larsen, Steven Allen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 9th, 2006 |
| Last updated | Sep 2nd, 2016 - about 8 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 | 1508953555 | NPPES |
| Idaho | MEDICAID | 807481100 | |
| Idaho | MEDICAID | 005925 |
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