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PAUL LARSON OB GYN CLINIC PA

Physicians Obstetrics & Gynecology Critical Care Medicine

Provider NPI: 1770547317

Organization Information:
Organization Name:  PAUL LARSON OB GYN CLINIC PA
Organization is not Subpart
Authorized Official:  MARTIN L. IMMERMAN  PRESIDENT  952-927-4021

Practice Location:
6525 FRANCE AVE S STE 100 EDINA, MN 55435-3624 US
Tel: 952-927-4021  Fax: 952-285-6183

Business Mailing Address:
6525 FRANCE AVE S STE 100 EDINA, MN 55435-2158 US
Tel: 952-927-4021  Fax: 952-285-6183

NPI Information:
NPI: 1770547317
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207VC0200XPhysicians
Obstetrics & Gynecology
Critical Care Medicine
Y207V00000XPhysicians
Obstetrics & Gynecology

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 207V00000X

Type:

Classification:



Definition:



MEDICAL JOBS MN - Page 1

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