Most Relevant Information
Provider Data
| NPI Number: | 1003064999 |
| Provider Name: | DOUGLAS GLEN LARSON M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2085R0202X |
| Specialty: | Radiology |
| License Number: | 15305 |
Most Important Dates
| Enumeration Date: | 09/04/2008 |
| Last Updated: | 10/03/2016 |
Provider Practice Location
2020 PALOMINO LN
#100
LAS VEGAS
NV
891064842
Practice Location Phone/Fax
| Phone: | 7027598600 |
| Fax: |
Provider Mailing Location
2020 PALOMINO LN
#100
LAS VEGAS
NV
891064842
Provider Mailing Phone/Fax
| Phone: | 7027598600 |
| Fax: |