Healthcare Provider Details

I. General information

NPI: 1639437890
Provider Name (Legal Business Name): AARON K CALODNEY M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MEDICAL CENTER BLVD SUITE C
LUFKIN TX
75904-3173
US

IV. Provider business mailing address

PO BOX 130459
TYLER TX
75713-0459
US

V. Phone/Fax

Practice location:
  • Phone: 936-631-6000
  • Fax: 936-631-6082
Mailing address:
  • Phone: 903-531-2500
  • Fax: 903-595-3785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AARON K CALODNEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 903-531-2500