BRAD RODNEY LARSEN P.A. NPI 1063430890

NPI Information

NPI: 1063430890
Provider Name: BRAD RODNEY LARSEN, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
2950 N CHURCH ST
STE 200
LAYTON, UT
ZIP 84040
Phone: (801) 771-7700
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Brad Rodney Larsen, P.A. is a medical physician assistant in Layton, UT with 24 years of experience. Brad Rodney Larsen, P.A. NPI is 1063430890. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2950 N CHURCH ST
STE 200
LAYTON, UT
ZIP 84040-504
Phone: (801) 771-7700
Fax: (801) 546-2422

The NPI 1063430890 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 12/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA0272	TEXAS	No
2	363AM0700X	Physician Assistant	Medical	5166627-1206	UTAH	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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