Healthcare Provider Details

I. General information

NPI: 1689014227
Provider Name (Legal Business Name): AARON PARKER BANKS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 09/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 KY HIGHWAY 7 S
SANDY HOOK KY
41171-0748
US

IV. Provider business mailing address

PO BOX 748
SANDY HOOK KY
41171-0748
US

V. Phone/Fax

Practice location:
  • Phone: 606-738-5155
  • Fax: 606-738-5420
Mailing address:
  • Phone: 606-738-5155
  • Fax: 606-738-5420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTP206
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04013
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: