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Jack Larsen
Family Medicine Physician in Johnson City, Tennessee
NPI 1972063444

Jack Larsen is a Family Medicine Physician based in Mountain Home, TN. Jack Larsen practices in Johnson City, TN. The NPI Number for Jack Larsen is 1972063444 and holds a License No. 63135 (Tennessee).

The current practice location address for Jack Larsen is 917 W Walnut St, Johnson City, TN and can be reached out via phone at 423-439-6464. You can also correspond with Jack Larsen through the mailing address at PO BOX 699, MOUNTAIN HOME, TN - 37684-0699 (mailing address contact number: 423-433-6050).

Location: 917 W Walnut St, Johnson City, TN, 37684-0699
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972063444
Provider Name
Jack Larsen
Credential
Provider Entity Type
Individual
Gender
Male
Address
917 W Walnut St, Johnson City, TN, 37684-0699
Phone Number
423-439-6464
Fax Number
Provider Enumeration Date
03/21/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
Q050572 05 TN
institution
Provider Business Practice Location Address Details
Address
917 W Walnut St
City
Johnson City
State
Tennessee
Zip
37604
Phone Number
423-439-6464
Fax Number
person
Provider Business Mailing Address Details
Address
917 W Walnut St
City
Johnson City
State
Tennessee
Zip
37604
Phone Number
423-439-6464
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
63135 (Tennessee)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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