Larson, Gizell R

Larson, Gizell R is an individual health care provider with primary practice located at 1305 W American Dr , Neenah WI 54956-1993. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Larson, Gizell R can be contacted via phone (920) 725-9373.

Contact Information

Primary practice address
1305 W American Dr Neenah WI 54956-1993
Fax: (920) 720-7392
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 26600 Wisconsin

Profile Details

NPI number 1629029707
LBN Legal business name Larson, Gizell R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2006
Last updated Feb 27th, 2012 - about 12 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 1629029707 NPPES
Wisconsin Other 001371450 MEDICARE
Wisconsin MEDICAID 30625000 MEDICARE

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