Harvard Lab & X-Ray, Inc

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

Legal business name

HARVARD LAB & X-RAY, INC

Practice address

1813 W Harvard Ave
Suite 102
Roseburg, OR 97470-2752

Phone

(541) 440-6316

Fax

(541) 464-4336

NPI assigned

Nov 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marlin Larsen, PHD, BLD

Title

Owner

Phone

(541) 672-9349

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629140793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE",
            "address_2": "SUITE 102",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702752",
            "telephone_number": "541-440-6316",
            "fax_number": "541-464-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE",
            "address_2": "SUITE 102",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702752",
            "telephone_number": "541-440-6316",
            "fax_number": "541-464-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD LAB & X-RAY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "MARLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-672-9349",
        "authorized_official_credential": "PHD, BLD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288032",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF OREGON",
            "identifier": "0000003290",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOUGLAS COUNTY IPA",
            "identifier": "166173",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "J0625",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Ann Hart, APRN
• Galen V Hartzell, MSW
• Harvard Chiropractic Clinic, P.C.
• Harvard Counseling Center
• Harvard Endodontics, LLC
• Nicholas James Harvey
• Debra Hash
• Landon Haslem, MD,PHD
• Jeremiah J Hatcher
• Ashli Ann Hatfield, OTR/L

• Body Imaging Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Body Imaging Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.