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Individual

DANA LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-3528
(918) 744-3529
Mailing address
1923 S UTICA AVE, STE E, TULSA, OK 74104-6520
(918) 744-3528
(918) 744-3529

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16757
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100210820A
OK
Enumeration date
07/03/2006
Last updated
01/19/2017
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