# DR. DEREK THOMAS LARSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1104165034
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 0102203897 | VA | Yes |
| 208D00000X | General Practice Physician | 0102203897 | VA | — |

## Other

- **Enumeration date:** 02/13/2013
- **Last updated:** 08/14/2023