STEPHEN LARSON (NPI# 1972980928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972980928 |
Entity Type | Individual |
Full Name | STEPHEN LARSON |
Credential | M.D. |
Practice Address |
1120 15th St Augusta GA 30912-3403 |
Mailing Address |
1120 15th St Ste Bi1056 Augusta GA 30912-0004 |
Practice Telephone | 7067218623 |
Practice Fax Number | 7067211459 |
Mailing Telephone | 7067213813 |
Enumeration Date | 2015-04-29 |
Last Update Date | 2020-06-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Y00000X | Otolaryngology | 85636 | GA | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
910 Madison Ave Ste 1031, Memphis, TN 381033403 | 9014487635 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487759619 | Stephen Mark Larson | Optometrist | 314 Main St S, Sauk Centre, MN 56378-1349 | 2006-09-13 |
1699883876 | Stephen James Larson | Dentist | 777 Cuesta Dr Ste 100, Mountain View, CA 94040-3765 | 2006-08-28 |
1649230160 | Stephen Larson | Psychologist | 352 Hommelville Rd, Saugerties, NY 12477-4205 | 2006-03-27 |
1568465201 | Stephen Larson | Nurse Anesthetist, Certified Registered | 112 E 5th Ave, Antigo, WI 54409-2710 | 2005-05-26 |
1851802680 | Stephen Michael Larson | Specialist | 6333 Telegraph Ave, Oakland, CA 94609-1359 | 2017-10-19 |
1700205382 | Stephen Nathaniel Larson | Veterinarian | 2845 Harlem Ave, Berwyn, IL 60402-2800 | 2014-04-10 |
1972733467 | Stephen A Larson | Social Worker | 1100 K Ave, La Grande, OR 97850-2131 | 2009-07-20 |
1033276357 | Stephen Joseph Larson | Dentist | 612 Rockdale Ave, Cincinnati, OH 45229-2919 | 2007-01-03 |
1386755775 | Stephen Larson | Emergency Medicine | 12303 De Paul Dr, Bridgeton, MO 63044-2512 | 2006-08-31 |
1003838459 | Stephen M Larson | Dentist | 6411 Fannin St, Houston, TX 77030-1501 | 2006-07-24 |
Street Address |
1120 15TH ST |
City | AUGUSTA |
State | GA |
Zip Code | 30912-3403 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427051556 | Gyanendra Kumar Sharma | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2005-05-23 |
1912508532 | Lacey Nichol Preston | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-11-02 |
1992302988 | Victoria Mae Pregibon | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-03 |
1275130239 | Tanya Renee Hall | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-02 |
1144847864 | Cassandra Marie Voong | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-29 |
1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
1639795990 | Lauren Christine Bush | Audiologist | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-23 |
1811513575 | Ashley Danielle Fox | Internal Medicine | 1120 15th St, Augusta, GA 30912-0006 | 2020-06-18 |
1265058994 | Matthew Craddock | Psychiatry & Neurology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-18 |
1437775301 | Joseph John Arellano | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
Find all providers in zip 30912 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922413343 | Colin Wyatt Fuller | Otolaryngology | 1120 Fifteenth St, Bp-4109, Augusta, GA 30912 | 2014-06-24 |
1356356158 | Frederick Nellis Klippert | Otolaryngology | 509 15th Street, Augusta, GA 30904-6285 | 2006-07-30 |
1811967227 | Erwin Bartholomeus Seywerd | Otolaryngology | 79 Arsenal St, Augusta, ME 04330-5704 | 2006-01-26 |
1407838527 | William Joseph Welsh | Otolaryngology | 1433 Stovall St, Augusta, GA 30904-4883 | 2005-11-15 |
1144873134 | Ranim A.m Alsharif | Otolaryngology | 1040 Alexander Dr, Augusta, GA 30909-0243 | 2019-07-19 |
1912560475 | Diana Jean Bigler | Otolaryngology | 1120 15th St, Augusta, GA 30912-0004 | 2019-04-19 |
1114412665 | Ahmad Mohamed Eltelety | Otolaryngology | 1120 15th St, Augusta, GA 30912-0004 | 2018-06-27 |
1437642188 | Lindsey Catherine Megow | Otolaryngology | 1120 15th St, Augusta, GA 30912-0004 | 2018-06-07 |
1417440298 | Trevor Wallace Getz | Otolaryngology | 1120 15th St, Augusta, GA 30912 | 2018-06-07 |
1043702186 | Jeffrey J. Falco | Otolaryngology | 1120 15th St, Augusta, GA 30912-0004 | 2018-06-05 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.