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Individual

JASON D LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2159 ROUTE 88 E, BRICK, NJ 08724-3232
(732) 899-0015
Mailing address
PO BOX 825159, PHILADELPHIA, PA 19182-5159

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
25MD00247600
NJ
213E00000X
Podiatrist
MD002476
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
MD002476
NJ
213ES0131X
Foot Surgery Podiatrist
Primary
25MD00247600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1088552
HORIZON NJ HEALTH
NJ
01
2K5453
HEALTHNET
NJ
05
9112600
NJ
01
P00139128
RAILROAD
NJ
01
P1134870
OXFORD
NJ
Enumeration date
03/08/2006
Last updated
01/12/2026
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