Provider Demographics
NPI:1790813608
Name:SANDERS, LARRY O (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:O
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W DAVIES AVE N
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120
Mailing Address - Country:US
Mailing Address - Phone:303-798-5002
Mailing Address - Fax:303-738-8708
Practice Address - Street 1:141 W DAVIES AVE N
Practice Address - Street 2:SUITE 107
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120
Practice Address - Country:US
Practice Address - Phone:303-798-5002
Practice Address - Fax:303-738-8708
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO291482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry