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NPI Code Detail

MEDICARE: DR. JORDAN LARSON DPM

MEDICARE: DR. JORDAN LARSON DPM
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
1213E00000XPodiatrist173517MT

General Provider Information

NPI Number : 1538857008
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORDAN LARSON DPM
Provider Business Mailing Address
First Line : 3990 AVENUE D
Second Line :
City : BILLINGS
State : MT
Zip : 59102-7531
Country : US
Telephone Number : 406-252-5444
Fax Number : 406-245-9043
Provider Business Practice Location Address
First Line : 3990 AVENUE D
Second Line :
City : BILLINGS
State : MT
Zip : 59102-7531
Country : US
Telephone Number : 406-252-5444
Fax Number : 406-245-9043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2023
Last Update Date : 06/24/2026

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