Provider Demographics
NPI:1073565354
Name:LARRIMER, JOHN N (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:N
Last Name:LARRIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:N
Other - Last Name:LARRIMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 BRADENTON AVE
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-7515
Mailing Address - Country:US
Mailing Address - Phone:614-793-1980
Mailing Address - Fax:614-793-1985
Practice Address - Street 1:6490 E MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2394
Practice Address - Country:US
Practice Address - Phone:614-367-0675
Practice Address - Fax:614-367-9744
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-03-4948207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0304094Medicaid
OH0304094Medicaid
OHA75669Medicare UPIN