Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 38048 | AZ |
N | 207VE0102X | Reproductive Endocrinologist | 38048 | AZ |
NPI | 1083773469 |
---|---|
Provider Name | Dr. Frederick W Larsen |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85258 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 25/10/2021 |