Larson, Gerald M

Larson, Gerald M is an individual health care provider with primary practice located at 401 E Chestnut St Suite 710, Louisville KY 40202-5700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Larson, Gerald M can be contacted via phone (502) 583-8303.

Contact Information

Primary practice address
401 E Chestnut St Suite 710 Louisville KY 40202-5700
Phone: (502) 583-8303
Fax: (502) 584-0302
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 21026 Kentucky

Profile Details

NPI number 1215917232
LBN Legal business name Larson, Gerald M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Jul 30th, 2009 - about 17 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 1215917232 NPPES
Kentucky Other 1052049 PASSPORT
Kentucky MEDICAID 64210263 PASSPORT
Kentucky MEDICAID 100348220B PASSPORT

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