Individual
LARRY P EBBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 MAUI LANI PKWY, WAILUKU, HI 96793-2416
(808) 442-5700
(808) 442-5652
Mailing address
6603 ELK CREEK RD, PIEDMONT, SD 57769-2032
(605) 484-1176
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
2083
SD
207RH0003X
Hematology & Oncology Physician
MC-274
GU
207RH0003X
Hematology & Oncology Physician
Primary
MD-21014
HI
207RX0202X
Medical Oncology Physician
74117
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008428
WELLMARK
SD
01
—
2083
DAKOTACARE
SD
05
—
6002482
—
SD
01
—
830007858
RR MEDICARE
SD
Enumeration date
09/27/2006
Last updated
03/16/2025
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