Larson, Keith D

Larson, Keith D is an sole proprietor health care provider with primary practice located at 1511 Northway Dr Suite 202, Saint Cloud MN 56303-1261. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, which is considered as his primary health care specialty. Larson, Keith D can be contacted via phone (320) 217-8880.

Contact Information

Primary practice address
1511 Northway Dr Suite 202 Saint Cloud MN 56303-1261
Phone: (320) 217-8880
Fax: (320) 253-1822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 22693 Minnesota

Profile Details

NPI number 1639138431
LBN Legal business name Larson, Keith D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 21st, 2006
Last updated Sep 1st, 2009 - about 15 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 1639138431 NPPES
Minnesota MEDICAID 313593400

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