Provider Demographics
NPI:1326036112
Name:LARGEN, REX F (MD)
Entity Type:Individual
Prefix:
First Name:REX
Middle Name:F
Last Name:LARGEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-0239
Mailing Address - Country:US
Mailing Address - Phone:402-423-7000
Mailing Address - Fax:402-473-9399
Practice Address - Street 1:5533 S 27TH STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-1664
Practice Address - Country:US
Practice Address - Phone:402-423-7000
Practice Address - Fax:402-423-9399
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17872207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0300105OtherUNITED HEALTHCARE
NE677OtherMIDLANDS CHOICE
NE91181700900Medicaid
NE32062OtherBC/BS
NE0300105OtherUNITED HEALTHCARE
NE91181700900Medicaid
NEF26163Medicare UPIN