Larson, Gary L
Larson, Gary L is an individual health care provider with primary practice located at 5911 W Memorial Rd , Oklahoma City OK 73142-2015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Larson, Gary L can be contacted via phone (405) 773-6530.Contact Information
Primary practice address
5911 W Memorial Rd
Oklahoma City OK 73142-2015
Phone: (405) 773-6530
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 13856 | Oklahoma |
Profile Details
| NPI number | 1578599304 |
|---|---|
| LBN Legal business name | Larson, Gary L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | May 21st, 2024 - about last year |
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 | 1578599304 | NPPES |
| Oklahoma | MEDICAID | 100088460A | |
| Oklahoma | Other | 300042703 |
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