Larson, Timothy L

Larson, Timothy L is an individual health care provider with primary practice located at 1401 Nwakama St , Marshall MN 56258-5529. 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, Timothy L can be contacted via phone (507) 929-7696.

Contact Information

Primary practice address
1401 Nwakama St Marshall MN 56258-5529
Phone: (507) 929-7696
Fax: (507) 393-7697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0386 South Dakota

Profile Details

NPI number 1982630828
LBN Legal business name Larson, Timothy L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Oct 31st, 2011 - about 15 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 1982630828 NPPES
South Dakota MEDICAID 6826122

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