Healthcare Provider Details

I. General information

NPI: 1265453831
Provider Name (Legal Business Name): AARON L EGBERT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MERCY CARDIOTHORACIC AND VASCULAR CLINIC 788 8TH AVENUE SE, SUITE 300
CEDAR RAPIDS IA
52401
US

IV. Provider business mailing address

MERCY CARDIOTHORACIC AND VASCULAR CLINIC 788 8TH AVENUE SE, SUITE 300
CEDAR RAPIDS IA
52401
US

V. Phone/Fax

Practice location:
  • Phone: 319-861-7200
  • Fax: 319-861-7201
Mailing address:
  • Phone: 319-861-7200
  • Fax: 319-861-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0281PA
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number001373
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: