David L Larson, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

27404 Issued in WI

Practice address

8700 Watertown Plank Road
Wisconsin Athletic Club BLDG
Milwaukee, WI 53226

Phone

(414) 805-3666

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Healthcare SC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1154371847
  NPD (past)
• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003867508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 W WATERTOWN PLANK RD",
            "address_2": "WISCONSIN ATHLETIC CLUB BUILDING",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 WATERTOWN PLANK ROAD",
            "address_2": "WISCONSIN ATHLETIC CLUB BLDG",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-805-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WI",
            "license": "27404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30711500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Larson, APRN
• Amy Elizabeth Larson, PA-C
• Christine Larson
• Daniel Larson, MSW
• Danielle Ione Larson
• Eric Larson, PH.D
• Gunnar L Larson, M.D.
• Jennifer Mary Larson, CCC-SLP
• Jerome Allen Larson, PSS
• Jessica Larson, BS, BS, MAFP, CSAC

• Plastic and Reconstructive Surgery Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Plastic and Reconstructive Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.