Provider Demographics
NPI:1316944192
Name:LARSON, LAUREN K (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:K
Last Name:LARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:280 PASADENA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2925
Mailing Address - Country:US
Mailing Address - Phone:859-278-1316
Mailing Address - Fax:859-278-9896
Practice Address - Street 1:2416 REGENCY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2954
Practice Address - Country:US
Practice Address - Phone:859-278-1316
Practice Address - Fax:859-276-1574
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36246208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1392787OtherUMWA
KY611142277OtherTRICARE
KY64055080Medicaid
KY000000240303OtherANTHEM
KY2125891OtherFIRST HEALTH
KY23-00145OtherUNITED HEALTHCARE
KY250013955OtherRAILROAD MCR
KY611142277OtherBLUEGRASS FAMILY HEALTH
KY611142277ROtherHUMANA
KY16363600OtherDOL
KY1200999OtherCHA
KY50002209OtherPASSPORT
KYK010972OtherCHAMPUS
KY0366222Medicare PIN
KY611142277OtherBLUEGRASS FAMILY HEALTH