Individual
RICHARD LEE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 HOSPITAL LOOP, BELCOURT, ND 58316-0160
(701) 477-6111
(701) 477-2507
Mailing address
P.O. BOX 160, BELCOURT, ND 58316-0160
(701) 477-6111
(701) 477-2507
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ND5215
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01063
—
ND
Enumeration date
09/22/2006
Last updated
12/06/2012
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