Provider Demographics
NPI:1922448158
Name:LARSON, DAVID RICHARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RICHARD
Last Name:LARSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10200 N 92ND ST STE 225
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4536
Mailing Address - Country:US
Mailing Address - Phone:480-697-4824
Mailing Address - Fax:480-697-4825
Practice Address - Street 1:10200 N 92ND ST STE 225
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4536
Practice Address - Country:US
Practice Address - Phone:480-697-4824
Practice Address - Fax:480-697-4825
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ865213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery