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NPI Code Detail

MEDICARE: SCOTT LARSON MD

MEDICARE:   SCOTT  LARSON  MD
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
1207L00000XAnesthesiology Physician7664795-1205UT

General Provider Information

NPI Number : 1154562973
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT LARSON MD
Provider Business Mailing Address
First Line : 8035 WILLOW STREAM DR
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84093-6411
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8035 WILLOW STREAM DR
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84093-6411
Country : US
Telephone Number : 202-431-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2009
Last Update Date : 01/05/2011

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Directions to “ SCOTT LARSON MD” Practice Location

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