Organization
LARSON PLASTIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN ERIC LARSON MD (CMO, CEO)
(520) 771-0177
Entity
Organization
Contact information
Practice address
7005 N ORACLE RD, TUCSON, AZ 85704-4329
(520) 771-0177
(520) 300-7316
Mailing address
7005 N ORACLE RD, TUCSON, AZ 85704-4329
(520) 771-0177
(520) 300-7316
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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