Larson, James D

Larson, James D is an individual health care provider with primary practice located at 975 Port Washington Rd Suite 320, Grafton WI 53024-9201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Larson, James D can be contacted via phone (262) 329-8100.

Contact Information

Primary practice address
975 Port Washington Rd Suite 320 Grafton WI 53024-9201
Phone: (262) 329-8100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X C7-0003751 Delaware
Allopathic & Osteopathic Physicians / Surgery 208600000X C1-0010142 Delaware
Allopathic & Osteopathic Physicians / Surgery 208600000X 60324 Wisconsin

Profile Details

NPI number 1164632410
LBN Legal business name Larson, James D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Nov 22nd, 2021 - about 5 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 1164632410 NPPES
Delaware Other C7-0003751 ACGME TRAINING LICENSE

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