Basic Information
Provider Information
NPI: 1215022306
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LARSON
FirstName: JOSHUA
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3340 NORTH CENTER ST
Address2: #800
City: LEHI
State: UT
PostalCode: 840437406
CountryCode: US
TelephoneNumber: 8019901911
FaxNumber:  
Practice Location
Address1: 1380 EAST MEDICAL CENTER DRIVE
Address2: DIXIE REGIONAL MEDICAL CENTER
City: ST. GEORGE
State: UT
PostalCode: 84790
CountryCode: US
TelephoneNumber: 4352511000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/04/2006
LastUpdateDate: 10/12/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XAM0443173-4854NHY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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