Provider Demographics
NPI:1710978739
Name:LARCOMBE, JOEL WALTER (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:WALTER
Last Name:LARCOMBE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:ROUTE 12 BLDG 449
Mailing Address - Street 2:NAVAL AMBULATORY CARE CENTER ATTN PROFESSIONAL AFFAIRS
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06349-5600
Mailing Address - Country:US
Mailing Address - Phone:860-694-2377
Mailing Address - Fax:860-694-2590
Practice Address - Street 1:ROUTE 12 BLDG 449
Practice Address - Street 2:NAVAL AMBULATORY CARE CENTER ATTN PROFESSIONAL AFFAIRS
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06349-5600
Practice Address - Country:US
Practice Address - Phone:860-694-2377
Practice Address - Fax:860-694-2590
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC35955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN