Individual
DR. THEODORE CARL LARSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11750 W 2ND PL, SUITE 255, LAKEWOOD, CO 80228
(720) 321-8040
(720) 321-8041
Mailing address
11750 W 2ND PL STE 255, LAKEWOOD, CO 80228-1726
(720) 321-8040
(720) 321-8041
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
44928
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4853580
—
CO
Enumeration date
09/25/2006
Last updated
07/05/2018
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