BRAD D LARSEN, PA-C, Medical APO, AE

Contact Information

BRAD D LARSEN, PA-C

31ST MEDICAL GROUP
UNIT 6180
APO, AE 09604

Phone: 314-632-5105
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Medical	363AM0700X	97	Physician Assistant
Family Medicine	207Q00000X	08	Physician/Family Practice
Student in an Organized Health Care Education/Training Program	390200000X

Indicates primary specialty

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NPI Profile & details for BRAD D LARSEN · (Male)

NPI Number	`1144700782`
Status	Active
Credentials	PA-C (Physician Assistant-Certified)
Entity	Individual
Enumeration date	08/14/2018
Last updated	08/17/2022 - About 4 years ago
Sole proprietor ¹	No
Identifiers	GA License # 1161415
Hospital affiliation(s)	Not Available

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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BRAD D LARSEN, PA-C – NPI #1144700782Medical

Contact Information

Specialty

Medical

Family Medicine

Student in an Organized Health Care Education/Training Program

NPI Profile & details for BRAD D LARSEN · (Male)

Reviews for BRAD D LARSEN

BRAD D LARSEN, PA-C – NPI #1144700782
Medical