# KEVIN J LARSEN

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

## Provider details

- **NPI number:** 1568465300
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 231 | NE | Yes |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 03/12/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0152470001 | DMERC CIGNA | NE |
| 01 | — | 02554 | BLUE CROSS BLUE SHIELD | NE |
| 01 | — | 280176 | MEDICARE | NE |
| 01 | — | 470624979 | CHAMPUS | NE |
| 05 | — | 47062497913 | — | NE |
| 01 | — | 480021904 | RAILROAD MEDICARE | NE |