Larson, Michael J

Larson, Michael J is an individual health care provider with primary practice located at 360 East Main , Rexburg ID 83440. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Larson, Michael J can be contacted via phone (208) 356-9550.

Contact Information

Primary practice address
360 East Main Rexburg ID 83440
Phone: (208) 356-9550
Fax: (208) 356-8023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X M-5158 Idaho
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X M5158 Idaho

Profile Details

NPI number 1518960087
LBN Legal business name Larson, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Dec 14th, 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 1518960087 NPPES
Idaho MEDICAID 003807100

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