MEDICARE: DR. LOUIS JOHN LARMOYEUX JR. DO

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	207Q00000X	Family Medicine Physician	OS 3002	FL

General Provider Information

NPI Number	:	1831193861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS JOHN LARMOYEUX JR. DO

Provider Business Mailing Address
First Line	:	PO BOX 45443
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84145-0443
Country	:	US
Telephone Number	:	904-202-1032
Fax Number	:	904-376-4107

Provider Business Practice Location Address
First Line	:	124 E ASHLEY ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32202-3118
Country	:	US
Telephone Number	:	904-353-5696
Fax Number	:	904-353-2844

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	12/28/2018

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