Individual
JOHN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1750 48TH ST, SUITE 2, DES MOINES, IA 50310-1988
(515) 271-6300
(515) 271-6311
Mailing address
PO BOX 4925, DES MOINES, IA 50305-4925
(515) 271-6300
(515) 271-6311
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18174
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21690
WELLMARK
IA
05
—
4134023
—
IA
Enumeration date
09/13/2006
Last updated
02/23/2010
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