Provider Demographics
NPI:1548328008
Name:DILLON, LARRY GENE (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:GENE
Last Name:DILLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4102 SAWMILL MESA RD
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-9158
Mailing Address - Country:US
Mailing Address - Phone:970-874-5838
Mailing Address - Fax:970-874-5885
Practice Address - Street 1:4102 SAWMILL MESA RD
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-9158
Practice Address - Country:US
Practice Address - Phone:970-874-5838
Practice Address - Fax:970-874-5885
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO15374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine