=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003971581
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AARON CLINIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2006
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 N WASHINGTON ST STE 4
-----------------------------------------------------
City | WEATHERFORD
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73096-5700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-772-3030
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 N WASHINGTON ST STE 4
-----------------------------------------------------
City | WEATHERFORD
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73096-5700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-772-3030
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MICHAEL E AARON
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 580-772-3030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------