MEDICARE: DR. LAUREN K LARSON 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	208VP0014X	Interventional Pain Medicine Physician	36246	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1392787	OTHER	KY	UMWA
2	611142277	OTHER	KY	TRICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000240303	OTHER	KY	ANTHEM
5	2125891	OTHER	KY	FIRST HEALTH
6	23-00145	OTHER	KY	UNITED HEALTHCARE
7	250013955	OTHER	KY	RAILROAD MCR
8	611142277	OTHER	KY	BLUEGRASS FAMILY HEALTH
9	611142277R	OTHER	KY	HUMANA
10	16363600	OTHER	KY	DOL
11	1200999	OTHER	KY	CHA
12	50002209	OTHER	KY	PASSPORT
13	K010972	OTHER	KY	CHAMPUS

General Provider Information

NPI Number	:	1316944192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN K LARSON M.D.

Provider Business Mailing Address
First Line	:	280 PASADENA DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2925
Country	:	US
Telephone Number	:	859-278-1316
Fax Number	:	859-278-9896

Provider Business Practice Location Address
First Line	:	2416 REGENCY RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2954
Country	:	US
Telephone Number	:	859-278-1316
Fax Number	:	859-276-1574

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/28/2016

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