Larson, John B

Larson, John B is an individual health care provider with primary practice located at 5109 New Cut Rd , Louisville KY 40214-2745. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Larson, John B can be contacted via phone (502) 361-1197.

Contact Information

Primary practice address
5109 New Cut Rd Louisville KY 40214-2745
Phone: (502) 361-1197
Fax: (502) 361-0090
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 18526 Kentucky

Profile Details

NPI number 1750332136
LBN Legal business name Larson, John B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Dec 11th, 2013 - about 12 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 1750332136 NPPES
Kentucky Other 000000050175 BLUE CROSS
Kentucky MEDICAID 6418526700 BLUE CROSS

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