IndividualActive
Charles Larson, M.D.
NPI 1184768129 · Adult Medicine Physician · Fox Lake, WI
Provider details
- NPI number
- 1184768129
- Entity type
- Individual
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 26821 (WI)
Practice location
Flci
W10237 Lake Emily Rd
Fox Lake, WI 54935-8525
Phone: (920) 928-6958
Fax: (920) 928-6951
Mailing address
W4455 Overland Trl
Fond Du Lac, WI 54935-8525
Registry dates
- Enumerated
- 2007-02-15
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.