Individual
DR. DOUGLAS GLEN LARSON
Active
Individual
DR. DOUGLAS GLEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
15305
NV
2085R0202X
Diagnostic Radiology Physician
Primary
MD172183
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003064999
—
CA
01
—
P01352399
RR DR
NV
01
—
P01418514
RR MEDICARE DRS
NV
Enumeration date
09/04/2008
Last updated
10/03/2016
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