Healthcare Provider Details

I. General information

NPI: 1093035172
Provider Name (Legal Business Name): AARON R KIRKPATRICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MEDICAL PKWY STE 419
CEDAR PARK TX
78613-5015
US

IV. Provider business mailing address

1650 W HARRISON ST STE 466
CHICAGO IL
60612-3800
US

V. Phone/Fax

Practice location:
  • Phone: 512-379-3636
  • Fax: 512-379-3641
Mailing address:
  • Phone: 312-942-5495
  • Fax: 312-942-5727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number245355
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036.135067
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number036.135067
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberT1121
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: