Male or Other

Douglas S. Larsen PA-C

Physician Assistant in Red Wing, MN(View on Map)

Full Name

Douglas Steven Larsen PA-C

NPI Number

1003128059

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/07/2010

Specialties

(Taxonomies)

Code

363A00000X
363AM0700X

Primary Taxonomy

Yes
No

Licenses

State

Minnesota
Wisconsin

License Number

12317
3095

Contact
Information

Purpose

Mailing
Location

Address

701 HEWITT BLVD
701 HEWITT BLVD

City

Red Wing
Red Wing

State

MN
MN

Postal Code

55066-2848
55066

Country

US
US

Telephone Number

(651) 267-5000
(651) 267-5000

Health Information Exchange

Endpoint Type

DIRECT

Endpoint

dlarsen88427@ehrdirect.mayoclinicmsg.org

Endpoint Description

Unknown

Use

Unknown

Content Type

Unknown

Affiliation

N

Endpoint Location

701 Hewitt BlvdRed Wing, MN55066US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/09/2020

Provider Address

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