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:
Health care specialties
Specialty | Code | License # | 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 4 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 | 1386806917 | NPPES |
Arizona | MEDICAID | 618036 |
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