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1336149467

NPI Code Detail

MEDICARE: BRIAN THOMAS LARKIN MD

MEDICARE: BRIAN THOMAS LARKIN 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
1	2085R0202X	Diagnostic Radiology Physician	28532	MN
2	2085R0204X	Vascular & Interventional Radiology Physician	28532	MN
3	2085N0700X	Neuroradiology Physician	28532	MN
4	2085B0100X	Body Imaging Physician	28532	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336149467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN THOMAS LARKIN MD

Provider Business Mailing Address
First Line	:	2800 CAMPUS DR
Second Line	:	#10
City	:	PLYMOUTH
State	:	MN
Zip	:	55441-2645
Country	:	US
Telephone Number	:	763-559-2171
Fax Number	:	763-694-9000

Provider Business Practice Location Address
First Line	:	3300 OAKDALE AVE N
Second Line	:
City	:	ROBBINSDALE
State	:	MN
Zip	:	55422-2926
Country	:	US
Telephone Number	:	763-559-2171
Fax Number	:	763-694-9000

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	03/03/2009

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Directions to “ BRIAN THOMAS LARKIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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