MEDICARE: MR. AARON C BORNSTEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	14650	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164489050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AARON C BORNSTEIN MD

Provider Business Mailing Address
First Line	:	2200 E SHOW LOW LAKE RD
Second Line	:
City	:	SHOW LOW
State	:	AZ
Zip	:	85901
Country	:	US
Telephone Number	:	928-537-6978
Fax Number	:	928-537-4205

Provider Business Practice Location Address
First Line	:	2352 QUARTER HORSE TRAIL
Second Line	:
City	:	OVERGAARD
State	:	AZ
Zip	:	85933
Country	:	US
Telephone Number	:	928-535-3616
Fax Number	:	928-535-3615

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	12/05/2018

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