Larson, Jeffrey E

Larson, Jeffrey E is an individual health care provider with primary practice located at 2424 S 90Th St Suite 500, West Allis WI 53227-2455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Larson, Jeffrey E can be contacted via phone (414) 328-8600.

Contact Information

Primary practice address
2424 S 90Th St Suite 500 West Allis WI 53227-2455
Phone: (414) 328-8600
Fax: (414) 328-8686
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 31144020 Wisconsin

Profile Details

NPI number 1124018809
LBN Legal business name Larson, Jeffrey E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Dec 10th, 2019 - about 6 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 1124018809 NPPES
Wisconsin MEDICAID 31597600
Wisconsin Other CG1663

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