MEDICARE: DR. DAVID RICHARD LARSON D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	865	AZ

General Provider Information

NPI Number	:	1922448158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RICHARD LARSON D.P.M.

Provider Business Mailing Address
First Line	:	10200 N 92ND ST STE 225
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4536
Country	:	US
Telephone Number	:	480-697-4824
Fax Number	:	480-697-4825

Provider Business Practice Location Address
First Line	:	10200 N 92ND ST STE 225
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4536
Country	:	US
Telephone Number	:	480-697-4824
Fax Number	:	480-697-4825

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

Provider Enumeration Date	:	07/02/2013
Last Update Date	:	08/07/2023

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Directions to “ DR. DAVID RICHARD LARSON D.P.M.” Practice Location

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