Healthcare Provider Details

I. General information

NPI: 1629019922
Provider Name (Legal Business Name): JOHN AARON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2147 WILMA RUDOLPH BLVD
CLARKSVILLE TN
37040
US

IV. Provider business mailing address

PO BOX 3799
CLARKSVILLE TN
37043
US

V. Phone/Fax

Practice location:
  • Phone: 931-245-8300
  • Fax: 931-245-8360
Mailing address:
  • Phone: 931-245-7094
  • Fax: 931-245-7069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16845
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number42101
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: