Provider Demographics
NPI:1114171014
Name:LARSON, BARRETT PAUL II (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:PAUL
Last Name:LARSON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:500 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1791
Mailing Address - Country:US
Mailing Address - Phone:952-442-2191
Mailing Address - Fax:952-442-8055
Practice Address - Street 1:560 S MAPLE ST STE 400
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1757
Practice Address - Country:US
Practice Address - Phone:952-442-8011
Practice Address - Fax:952-442-7852
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2018-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN58802207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine