| Brian J Larson, MD | |
|
3485 Independence Dr, Homewood, AL 35209-5603 | |
| (205) 414-4402 | |
| (205) 414-4425 |
| Full Name | Brian J Larson |
|---|---|
| Gender | Male |
| Speciality | Radiology - Radiation Oncology |
| Location | 3485 Independence Dr, Homewood, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861498370 | NPI | - | NPPES |
| 0366100001 | Other | AL | MC NSC |
| P00462711 | Other | AL | RAILROAD MEDICARE PTAN |
| 0366100001 | Other | AL | CIGNA GOVERNMENT SERVICES PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 11787 (Alabama) | Primary |
| Entity Name | Urology Centers Of Alabama, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710962550 PECOS PAC ID: 0941264345 Enrollment ID: O20041116000389 |
| Mailing Address | Practice Location Address |
|---|---|
| Brian J Larson, MD 3485 Independence Dr, Homewood, AL 35209-5603 Ph: (205) 414-4402 | Brian J Larson, MD 3485 Independence Dr, Homewood, AL 35209-5603 Ph: (205) 414-4402 |
Anthony Chuprin, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 3485 Independence Dr, Homewood, AL 35209 Phone: 205-930-0920 | |
Ghulam Hussain Thaver, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3485 Independence Dr, Homewood, AL 35209 Phone: 205-930-0920 Fax: 205-445-0115 |