Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shane Lyle Larson, MD

Individual provider Family Medicine Physician · NPI 1750601191

Dr. Shane Lyle Larson, MD is a Family Medicine Physician in Fort Eustis, Virginia. Works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2010
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

576 Jefferson Ave
Fort Eustis, VA 23604-1373
Phone: (757) 820-1043
Fax: (757) 820-1122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2817 Reilly Road, Fort Bragg, NC 28310 — (910) 643-1427

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 67238 (GA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 67238 (GA)

Record details

NPI number1750601191
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 8, 2010
Last updated in NPPESApril 27, 2022
Certification dateApril 27, 2022
Mailing address576 Jefferson Ave, Fort Eustis, VA 23604-1373

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