DR. CHARLES E LARSON (NPI# 1184768129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184768129 |
| Entity Type | Individual |
| Full Name | DR. CHARLES E LARSON |
| Credential | M.D. |
| Practice Address |
Flci W10237 Lake Emily Rd Fox Lake WI 54935-8525 |
| Mailing Address |
W4455 Overland Trl Fond Du Lac WI 54935-8525 |
| Practice Telephone | 9209286958 |
| Practice Fax Number | 9209286951 |
| Mailing Telephone | 9209249630 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
26821 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497120349 | Charles Blaise Larson | Nurse Practitioner | 730 N College Rd Ste B, Twin Falls, ID 83301-3382 | 2015-12-03 |
| 1437589181 | Charles Larson | Orthopaedic Surgery | 2431 Park Hill Dr, Longview, WA 98632-5785 | 2013-11-16 |
| 1588992291 | Charles Keith Larson | Pharmacist | 800 N Zaragoza Rd, El Paso, TX 79907-2519 | 2009-11-19 |
| 1326076217 | Charles P Larson Jr. | Anesthesiology | 300 Pasteur Dr, Stanford, CA 94305-2200 | 2006-06-29 |
| 1013973353 | Charles A Larson | Family Medicine | 2337 Homer Clayton Drive, Guntersville, AL 35976 | 2006-04-25 |
| 1518952209 | Charles C Larson | Internal Medicine | 5950 University Ave, Ste 221, West Des Moines, IA 50266-8216 | 2005-09-19 |
| Street Address |
FLCI W10237 LAKE EMILY RD |
| City | FOX LAKE |
| State | WI |
| Zip Code | 54935-8525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427214501 | Muzaffar Baig Mirza | Family Medicine | 2976 Edenberry St, Fitchburg, WI 53711-6950 | 2008-07-29 |
| 1720101447 | Robert G Montgomery | Family Medicine | 8570 S 116th St, Franklin, WI 53132-8803 | 2007-04-09 |
| 1447388350 | Robert Earl Kerwin Jr. | Family Medicine | 333 E. Campus Mall, Madison, WI 53715-1381 | 2007-03-01 |
| 1154411486 | Paul Henry Hunter | Family Medicine | 841 N Broadway Rm 315, Milwaukee, WI 53202-3613 | 2006-10-16 |
| 1851310411 | Steven Ronald Coenen | Family Medicine | 10 Triparkway, Va Clinic, Appleton, WI 54914 | 2006-07-18 |
| 1285688713 | Deborah A Luetzow | Family Medicine | 2413 W Rawson Ave, Oak Creek, WI 53154-1323 | 2006-05-20 |
| 1548257124 | Paul Hankwitz | Family Medicine | 8520 W Oklahoma Ave, Milwaukee, WI 53227-4604 | 2005-09-29 |
| 1184155194 | Richard Edgar Rieselbach | Family Medicine | 2711 Allen Blvd, Middleton, WI 53562 | 2017-03-22 |
| 1275978983 | Numale Medical Center LLC | Family Medicine | 2600 N Mayfair Rd, Suite 505, Wauwatosa, WI 53226-1309 | 2013-05-08 |
| 1376851311 | Progressive Community Health Centers, Inc | Family Medicine | 1452 N 7th St, 2nd Floor, Milwaukee, WI 53205-2301 | 2010-09-23 |
| Find all providers with the same taxonomy | ||||
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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.