Individual
DR. DANIEL A LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1222 S PATTERSON BLVD, SUITE 400, DAYTON, OH 45402-2684
(937) 496-2620
(937) 496-2610
Mailing address
1222 S PATTERSON BLVD, STE 400, DAYTON, OH 45402-2642
(228) 376-0420
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35-130667
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236207
—
OH
01
—
H584930
MEDICARE
OH
Enumeration date
06/26/2008
Last updated
02/22/2021
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