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Contact Information

EVERETT W LARSEN, M.D.
1786 N MAIN ST
CENTERVILLE, UT84014-1133
 Phone: 801-599-5905
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for EVERETT W LARSEN · (Male)

NPI Number 1164450821
Status Active
Credentials M.D.
Entity Individual
Enumeration date 06/29/2006
Last updated 04/23/2026 - About 1 months ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 187423-1205
  • UT Medicaid 11084
Hospital affiliation(s)
  • LAKEVIEW HOSPITAL - (Acute Care)
    630 EAST MEDICAL DRIVE
    BOUNTIFUL, UT 84010
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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