Larson, Theresa A

Larson, Theresa A is an individual health care provider with primary practice located at 608 Stanton L Young Blvd , Oklahoma City OK 73104-5014. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Larson, Theresa A can be contacted via phone (405) 271-6060.

Contact Information

Primary practice address
608 Stanton L Young Blvd Oklahoma City OK 73104-5014
Phone: (405) 271-6060
Fax: (405) 271-3649
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 48676 Minnesota

Profile Details

NPI number 1881606739
LBN Legal business name Larson, Theresa A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Nov 17th, 2022 - 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 1881606739 NPPES
Wisconsin MEDICAID ENROLLED
Wisconsin MEDICAID 403688000
Wisconsin Other P00629415
Wisconsin MEDICAID ENROLLED

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