Larson, Kenneth B

Larson, Kenneth B is an individual health care provider with primary practice located at 1600 S 20Th Ave , Safford AZ 85546-4011. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Larson, Kenneth B can be contacted via phone (928) 348-4021.

Contact Information

Primary practice address
1600 S 20Th Ave Safford AZ 85546-4011
Phone: (928) 348-4021
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1090 Arizona

Profile Details

NPI number 1043379829
LBN Legal business name Larson, Kenneth B
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2006
Last updated Feb 21st, 2017 - about 9 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 1043379829 NPPES
Arizona MEDICAID 184841

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