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Individual
PENNY LEE LARSON
Active
Individual
PENNY LEE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01051820A
IN
207V00000X
Obstetrics & Gynecology Physician
55075
GA
207V00000X
Obstetrics & Gynecology Physician
Primary
A93985
CA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
A93985
CA
Other
Enumeration date
10/17/2005
Last updated
06/15/2023
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