MEDICARE: DR. DURGA S. LARKIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MD07869	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	180039474	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	004475	OTHER		BLUE CHIP
2	324	OTHER	RI	BLUE CROSS BLUE SHIELD
3	2233622	OTHER		AETNA HMO
4	3033	OTHER		NEIGHBORHOOD HEALTH
5	7117047	OTHER		AETNA NON HMO
7	3253450001	OTHER		CIGNA
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	R001038	OTHER		TRICARE
10	050369447	OTHER		VISION SERVICE PLAN
11	0800670	OTHER	RI	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1063466324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DURGA S. LARKIN M.D.

Provider Business Mailing Address
First Line	:	150 EAST MANNING ST.
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02906
Country	:	US
Telephone Number	:	401-272-2020
Fax Number	:	401-421-5979

Provider Business Practice Location Address
First Line	:	55 VILLAGE SQUARE DRIVE
Second Line	:	BUILDING 24
City	:	SOUTH KINGSTOWN
State	:	RI
Zip	:	02879
Country	:	US
Telephone Number	:	401-272-2020
Fax Number	:	401-789-4113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	09/18/2013

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Directions to “ DR. DURGA S. LARKIN M.D.” Practice Location

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