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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. CHARLES E LARSON, M.D.

Active Sole Proprietor

DR. CHARLES E LARSON, M.D. is a Adolescent Medicine healthcare provider located in FOX LAKE, Wisconsin. NPI 1184768129 is currently active in the NPPES registry. Verify at CMS.

Adolescent Medicine · FOX LAKE, WI

Registration Details

NPI Number
1184768129
Provider Type
Individual
Gender
Male
NPI Issued
Feb 15, 2007 (19.50623704298 yrs)
Last Updated
Jul 8, 2007
License
26821 (WI)
Sole Proprietor
Yes

Practice Information

Address
FLCI
W10237 LAKE EMILY RD
FOX LAKE, WI, 549358525
Browse WI providers · Browse ZIP 54935
Phone
9209286958
Fax
9209286951
Primary Specialty
Adolescent Medicine
207QA0505X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.