Provider Demographics
NPI:1750335964
Name:LARSON-OHLSEN, KIMBERLY KAY (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:KAY
Last Name:LARSON-OHLSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-690-2198
Mailing Address - Fax:303-369-1807
Practice Address - Street 1:1400 S POTOMAC ST
Practice Address - Street 2:#220
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4528
Practice Address - Country:US
Practice Address - Phone:303-690-2198
Practice Address - Fax:303-369-1807
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2019-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO38587207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80823726Medicaid
CO80823726Medicaid
COP01474643Medicare PIN
COCOA104324Medicare PIN