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PAUL LARSON M.D. NPI 1124091749


NPI Information

NPI: 1124091749
Provider Name: PAUL LARSON, M.D.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

Organization: PROHEALTH MEDICAL GROUP INC.

PECOS Registration: Yes

Address:
721 AMERICAN AVENUE SUITE 501
PHC BEHAVIORAL MEDICINE CENTER
WAUKESHA, WI
ZIP 53188
Phone: (262) 928-2396
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Paul Larson, M.D. is a child and adolescent psychiatry psychiatry neurology in Waukesha, WI with 28 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Paul Larson, M.D. NPI is 1124091749. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SANFORD SCHOOL OF MEDICINE OF UNIVERSITY OF SOUTH DAKOTA
Graduation Year:1996

The provider's business location address is:

721 AMERICAN AVENUE SUITE 501
PHC BEHAVIORAL MEDICINE CENTER
WAUKESHA, WI
ZIP 53188
Phone: (262) 928-2396
Fax: (262) 544-1213

The NPI 1124091749 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 2/13/2006 and was last updated on 4/25/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry39093WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H46225MEDICARE UPINWISCONSIN
234096900MEDICAIDWISCONSIN
384767MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.