Healthcare Provider Details

I. General information

NPI: 1447296207
Provider Name (Legal Business Name): AARON ROBERT BILLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 AVENUE H
POWELL WY
82435
US

IV. Provider business mailing address

777 AVENUE H
POWELL WY
82435
US

V. Phone/Fax

Practice location:
  • Phone: 307-754-7257
  • Fax: 307-754-1191
Mailing address:
  • Phone: 307-754-7257
  • Fax: 307-754-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number7737A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number7737A
License Number StateWY
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7737A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: