Healthcare Provider Details

I. General information

NPI: 1518107242
Provider Name (Legal Business Name): AARON B STEIN MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E REDSTONE AVE STE A
CRESTVIEW FL
32539-5322
US

IV. Provider business mailing address

175 MAIN STREET UNIT 235
DESTIN FL
32541-9998
US

V. Phone/Fax

Practice location:
  • Phone: 850-689-8004
  • Fax: 850-475-2669
Mailing address:
  • Phone: 850-475-2668
  • Fax: 850-475-2669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD D CHIPMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 850-475-2668