Individual
DR. DOUGLAS PAUL LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV NEUROLOGY PEDIATRICS, SAINT LOUIS, MO 63110-1002
(314) 362-1408
(314) 454-2523
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1408
(314) 454-2523
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
2008018552
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209035401
—
MO
Enumeration date
07/03/2008
Last updated
04/17/2025
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