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General NPI Number Information
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NPI Number | 1790813608
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Entity Type | Individual
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Provider Name | LARRY O SANDERS MD
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 141 W DAVIES AVE N SUITE 107
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City | LITTLETON
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State | CO
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Zip | 80120
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Country | US
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Telephone | 303-798-5002
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Fax | 303-738-8708
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Provider Business Mailing Address
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Address Line | 141 W DAVIES AVE N SUITE 107
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City | LITTLETON
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State | CO
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Zip | 80120
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Country | US
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Telephone | 303-798-5002
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Fax | 303-738-8708
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 29148
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License Number State | CO
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