# KYLE JAMES LARSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386966133
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11595 | SD | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | 11595 | SD | Yes |

## Other

- **Enumeration date:** 02/22/2010
- **Last updated:** 07/16/2024