Individual provider · Type 1 NPI

Charles E. Larson, MD

Adult Medicine Physician · Fox Lake, WI

NPI number 1184768129 Active

Practice location

Flci, W10237 Lake Emily Rd
Fox Lake, WI 54935-8525

Call (920) 928-6958 Map

Fax (920) 928-6951

Mailing address

W4455 Overland Trl
Fond Du Lac, WI 54935-8525

Specialties and licenses

Taxonomy	Code	License
Adult Medicine Physician Primary	207QA0505X	26821 (WI)

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

About NPI 1184768129

Charles E. Larson, MD's National Provider Identifier is 1184768129, issued on Feb 15, 2007. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Fox Lake, WI. The record was last updated on Jul 8, 2007.