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Individual

EUGENE DOUGLAS LARSEN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
280 N HOSPITAL DR STE 4, PRICE, UT 84501
(435) 637-5690
(435) 637-9809
Mailing address
415 N 1095 W, PRICE, UT 84501-4243
(435) 637-5690
(435) 637-9809

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9336977-1204
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447513221
UT
Enumeration date
06/18/2012
Last updated
08/22/2018
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