Individual
STUART LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 DANIEL DR, DANVILLE, KY 40422-2527
(859) 239-5570
Mailing address
PO BOX 990, DANVILLE, KY 40423-0990
(859) 239-2360
(859) 239-5579
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
27652
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
05
—
30615058
—
KY
01
—
K0184401
MEDICARE PTAN
KY
Enumeration date
01/11/2007
Last updated
02/28/2023
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