Larson, Jay C

Larson, Jay C is an individual health care provider with primary practice located at 5750 W Thunderbird Rd Ste G700 , Glendale AZ 85306. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Larson, Jay C can be contacted via phone (602) 938-3600.

Contact Information

Primary practice address
5750 W Thunderbird Rd Ste G700 Glendale AZ 85306
Phone: (602) 938-3600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 0729 Arizona
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 5901002297 Michigan
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0729 Arizona

Profile Details

NPI number 1386806917
LBN Legal business name Larson, Jay C
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2008
Last updated Jul 20th, 2021 - about 3 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 1386806917 NPPES
Arizona MEDICAID 618036

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