Healthcare Provider Details

I. General information

NPI: 1023272069
Provider Name (Legal Business Name): AARON CHRISTOPHER HURLBUT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12368 STRATFORD DR SUITE 300
CLIVE IA
50325-8162
US

IV. Provider business mailing address

3100 150TH ST
URBANDALE IA
50323-1628
US

V. Phone/Fax

Practice location:
  • Phone: 402-560-2691
  • Fax:
Mailing address:
  • Phone: 402-560-2691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301093032
License Number StateMI

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: