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NPI Code Detail

MEDICARE: MR. PAUL D. LARSEN MD

MEDICARE:  MR. PAUL D. LARSEN  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
1174400000XSpecialist18309NE
22084N0402XNeurology with Special Qualifications in Child Neurology Physician18309NE

General Provider Information

NPI Number : 1669474110
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL D. LARSEN MD
Provider Business Mailing Address
First Line : 988102 NEBRASKA MEDICAL CENTER
Second Line :
City : OMAHA
State : NE
Zip : 68198-8102
Country : US
Telephone Number : 402-559-6195
Fax Number :
Provider Business Practice Location Address
First Line : EMILE 42ND ST
Second Line :
City : OMAHA
State : NE
Zip : 68198-0001
Country : US
Telephone Number : 402-955-8125
Fax Number : 402-955-8140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 02/11/2016

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Directions to “ MR. PAUL D. LARSEN MD” Practice Location

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