Basic Information
| Provider Information | |||||||||
| NPI: | 1457309213 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LARKIN | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5063 S. COTTONWOOD STREET | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841078100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015077400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5770 S 250 E | ||||||||
| Address2: | SUITE 290 | ||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841078100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013144240 | ||||||||
| FaxNumber: | 8013144246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 02/12/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 1595771205 | UT | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 870390840 | 01 | TX | TAX ID | OTHER |