Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 76564 | FL |
NPI | 1164432514 |
---|---|
Provider Name | Dr. Larry Steve Atkinson |
First Address | Seminole, FL 33776-3715 |
Second Address | Seminole, FL 33776-3715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |