Healthcare Provider Details

I. General information

NPI: 1699834655
Provider Name (Legal Business Name): RYAN LARSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WHEELING ST
AURORA CO
80045-7211
US

IV. Provider business mailing address

1700 WHEELING ST
AURORA CO
80045-7211
US

V. Phone/Fax

Practice location:
  • Phone: 720-723-3094
  • Fax:
Mailing address:
  • Phone: 720-723-3094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0072266
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: