Provider Demographics
NPI:1891791414
Name:BEST, LARRY (DPM)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:BEST
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-4045
Mailing Address - Country:US
Mailing Address - Phone:260-499-0888
Mailing Address - Fax:260-846-6614
Practice Address - Street 1:400 1/2 UNION STREET
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:IN
Practice Address - Zip Code:46761
Practice Address - Country:US
Practice Address - Phone:260-499-0888
Practice Address - Fax:260-846-6614
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000564A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
215860AMedicare ID - Type Unspecified
T34637Medicare UPIN
IN6054790001Medicare NSC
IN5494530001Medicare NSC