Larsen, Timothy C

Larsen, Timothy C is an individual health care provider with primary practice located at 1818 N Meade St , Appleton WI 54911-3454. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Larsen, Timothy C can be contacted via phone (920) 731-4101.

Contact Information

Primary practice address
1818 N Meade St Appleton WI 54911-3454
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 45036-20 Wisconsin

Profile Details

NPI number 1760417760
LBN Legal business name Larsen, Timothy C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jul 9th, 2007 - about 17 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 1760417760 NPPES
Wisconsin MEDICAID 34388900

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