Larson, Kenneth W.
Larson, Kenneth W. is an individual health care provider with primary practice located at 1900 S National Ave Suite 1950, Springfield MO 65804-2265. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Larson, Kenneth W. can be contacted via phone (417) 820-7250.Contact Information
Primary practice address
1900 S National Ave Suite 1950
Springfield MO 65804-2265
Phone: (417) 820-7250
Fax: (417) 820-7255
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 105284 | Missouri |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 105284 | Missouri |
Profile Details
| NPI number | 1689741795 |
|---|---|
| LBN Legal business name | Larson, Kenneth W. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2006 |
| Last updated | May 2nd, 2013 - about 11 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 | 1689741795 | NPPES |
| Missouri | MEDICAID | 207672502 | |
| Missouri | Other | 431560263 |
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