Individual
CONSTANCE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905-5650
(706) 787-5811
Mailing address
300 EAST HOSPITAL RD, FORT GORDON, GA 30905-5650
(706) 787-1745
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
83968
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2018
Last updated
06/24/2025
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