Individual
MR. LARRY E. WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
130 KATE IRELAND DR, HYDEN, KY 41749-9071
(606) 672-2341
(606) 672-5254
Mailing address
130 KATE IRELAND DR, HYDEN, KY 41749-9071
(606) 672-2341
(606) 672-5254
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02875
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000503474
ANTHEM BCBS
KY
01
—
1388019
MEDICARE
KY
05
—
64100514
—
KY
01
—
C92475
CHI
KY
Enumeration date
12/15/2005
Last updated
08/26/2024
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