Individual
DR. BOBBY HAROLD LARSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
125 RANDOLPH RD, OAK RIDGE, TN 37830-5028
(865) 482-7565
(865) 482-7551
Mailing address
125 RANDOLPH RD, OAK RIDGE, TN 37830-5028
(865) 482-7565
(865) 482-7551
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
89OD
KY
152W00000X
Optometrist
Primary
OD0677
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0122010
CLARITY VISION
TN
01
—
3123670
BLUE CROSS BLUE SHIELD
NE
01
—
44608
DAVIS VISION
TN
Enumeration date
01/24/2006
Last updated
07/08/2007
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