Larson, Michael J
Larson, Michael J is an individual health care provider with primary practice located at 360 East Main , Rexburg ID 83440. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Larson, Michael J can be contacted via phone (208) 356-9550.Contact Information
Primary practice address
360 East Main
Rexburg ID 83440
Phone: (208) 356-9550
Fax: (208) 356-8023
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | M-5158 | Idaho |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | M5158 | Idaho |
Profile Details
| NPI number | 1518960087 |
|---|---|
| LBN Legal business name | Larson, Michael J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Dec 14th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518960087 | NPPES |
| Idaho | MEDICAID | 003807100 |
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