Individual
DR. STEVEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
326 POPLAR ST, BLACKFOOT, ID 83221-1741
(208) 785-5801
(208) 785-3504
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-5801
(208) 785-3504
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O-152
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010001960
REGENCE BLUE SHIELD
ID
01
—
000010167600
RBS LAMERE
ID
05
—
002331000
—
ID
01
—
266528
ALTIUS OLD
ID
01
—
312970
ALTIUS
ID
01
—
S5601
BLUE CROSS OLD
ID
01
—
S6115
BLUE CROSS ID
ID
01
—
S6243
BCS LAMERE
ID
Enumeration date
05/05/2006
Last updated
07/25/2008
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