Individual
DR. JORDAN REEVE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
940 NE 13TH ST, GT 2300, OKLAHOMA CITY, OK 73104-5008
(405) 271-2429
Mailing address
940 NE 13TH ST, GT 2300, OKLAHOMA CITY, OK 73104-5008
(405) 271-2429
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
5764
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2012
Last updated
07/06/2015
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