Individual
MR. NICHOLAS JAMES LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
(770) 701-6675
Mailing address
PO BOX 3570, SALT LAKE CITY, UT 84110-3570
(801) 727-2056
(770) 701-6675
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
148134
MT
207L00000X
Anesthesiology Physician
3084-321
WI
207L00000X
Anesthesiology Physician
Primary
7650570-1204
UT
207L00000X
Anesthesiology Physician
DO-07085
IA
207L00000X
Anesthesiology Physician
DO222362
OR
Other
Enumeration date
05/03/2007
Last updated
07/25/2025
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