Jeffrey A Larsen (NPI# 1609062363, PAC ID# 8729056668) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1609062363 |
| PAC ID by PECOS | 8729056668 |
| Professional Enrollment ID | I20150923002445 |
| Full Name | Jeffrey A Larsen |
| Organization Legal Name | SOUTH PENINSULA HOSPITAL INC |
| Address |
4300 Bartlett St Homer AK 99603-7005 |
| Phone Number | 9072358101 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1995 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 5395636930 |
| Number of Group Practice Members | 32 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 021306 | PROVIDENCE KODIAK ISLAND MEDICAL CTR |
| 021313 | SOUTH PENINSULA HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4300 Bartlett St, Homer, AK 99603-7005 | 9072358101 | SOUTH PENINSULA HOSPITAL INC |
| 1915 E Rezanof Dr, Kodiak, AK 99615-6602 | 9074863281 | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| Organization Legal Name | SOUTH PENINSULA HOSPITAL INC |
| Physicians | 29 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David R Downey | Family Medicine | South Peninsula Hospital Inc | 203 W Pioneer Ave, Suite 2, Homer, AK 99603-7527 |
| Paul L Eneboe | Family Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Donna J Rollins | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Anna Williams | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Kathryn Hurley Ostrom | Obstetrics/gynecology | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Lisa Milam | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Sarah L Roberts | Family Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Brent Adcox | Orthopedic Surgery | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Jill M Rife | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Dharti R Patel | Physician Assistant | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Street Address |
4300 BARTLETT ST |
| City | HOMER |
| State | AK |
| Zip | 99603-7005 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul L Eneboe | Family Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Donna J Rollins | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Anna Williams | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Kathryn Hurley Ostrom | Obstetrics/gynecology | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Lisa Milam | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Sarah L Roberts | Family Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Brent Adcox | Orthopedic Surgery | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Jill M Rife | Nurse Practitioner | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Dharti R Patel | Physician Assistant | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Jon F Lieberman | General Surgery | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bonnie M Turner | Nurse Practitioner | Chugachmiut | 5530 Main St, Port Graham, AK 99603-5530 |
| Edson L Knapp | Diagnostic Radiology | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Brian Mccorison | Certified Registered Nurse Anesthetist (crna) | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Giulia M Tortora | Family Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Christy L Martinez | Family Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Rona S Haberman | Clinical Social Worker | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Ross William Dodge | Internal Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Tyler C Moffett | Internal Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Renda K Knapp | Obstetrics/gynecology | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Teresa K Johnson | Family Medicine | South Peninsula Hospital Inc | 4300 Bartlett St, Homer, AK 99603-7005 |
| Find all physicians in zip 99603 | |||
| City | HOMER |
| Zip Code | 99603 |
| Specialty | GENERAL SURGERY |
| City + Specialty | HOMER + GENERAL SURGERY |
Please comment or provide details below to improve the information on Jeffrey A Larsen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.