Carson, Larry Van
Carson, Larry Van is an individual health care provider with primary practice located at 11104 Parkview Circle Dr Ste 110 , Fort Wayne IN 46845-1673. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Carson, Larry Van can be contacted via phone (260) 425-6780.Contact Information
Primary practice address
11104 Parkview Circle Dr Ste 110
Fort Wayne IN 46845-1673
Phone: (260) 425-6780
Fax: (260) 425-6615
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 0101039834 | Virginia |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 20197 | Georgia |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 2008-02090 | North Carolina |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 14284 | West Virginia |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 25835 | Tennessee |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 01082907A | Indiana |
Profile Details
| NPI number | 1588764385 |
|---|---|
| LBN Legal business name | Carson, Larry Van |
| Credentials | M.D., MBA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jun 12th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588764385 | NPPES |
| West Virginia | MEDICAID | 0089635000 | |
| West Virginia | MEDICAID | 5911722 |
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