Provider Demographics
NPI:1417154063
Name:LARSON, EMILY CLAIRE (DO)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CLAIRE
Last Name:LARSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:802 N RIVERSIDE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2502
Mailing Address - Country:US
Mailing Address - Phone:816-271-7979
Mailing Address - Fax:816-271-7971
Practice Address - Street 1:802 N RIVERSIDE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2502
Practice Address - Country:US
Practice Address - Phone:816-271-7979
Practice Address - Fax:816-271-7971
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2017-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2010017411207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology