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Individual

JEREMY T LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-3600
(937) 641-5802
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-3000

Taxonomy

Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
35.072406
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2010844
OH
Enumeration date
09/07/2005
Last updated
10/13/2023
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