=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063419562
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN S AUMILLER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2005
-----------------------------------------------------
Last Update Date | 10/28/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1250 BEN ALI DR
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40422-8937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-236-6621
-----------------------------------------------------
Fax | 859-238-0471
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1250 BEN ALI DR PO BOX 88
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40422-8937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-236-6621
-----------------------------------------------------
Fax | 859-238-0471
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 27430
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------