Individual
MR. LARRY K CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3525 S NATIONAL AVE, STE 101, SPRINGFIELD, MO 65807-7310
(417) 269-9950
(417) 269-9959
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R2D20
MO
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
R2D20
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201827912
—
MO
Enumeration date
06/20/2005
Last updated
06/10/2019
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