Larsen, Kevin J

Larsen, Kevin J is an individual health care provider with primary practice located at 620 N Diers Ave Ste 100 , Grand Island NE 68803-4985. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Larsen, Kevin J can be contacted via phone (308) 381-0404.

Contact Information

Primary practice address
620 N Diers Ave Ste 100 Grand Island NE 68803-4985
Phone: (308) 381-0404
Fax: (308) 381-0408
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 231 Nebraska

Profile Details

NPI number 1568465300
LBN Legal business name Larsen, Kevin J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Mar 12th, 2018 - about 8 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 1568465300 NPPES
Nebraska Other 280176 MEDICARE
Nebraska Other 02554 MEDICARE
Nebraska Other 0152470001 MEDICARE
Nebraska Other 470624979 MEDICARE
Nebraska Other 480021904 MEDICARE
Nebraska MEDICAID 47062497913 MEDICARE

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