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NPI Code Detail

MEDICARE: DR. AARON J SACKETT MD

MEDICARE: DR. AARON J SACKETT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician01059356AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023012440
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AARON J SACKETT MD
Provider Business Mailing Address
First Line : 7910 W JEFFERSON BLVD
Second Line : STE 201
City : FORT WAYNE
State : IN
Zip : 46804-4159
Country : US
Telephone Number : 260-436-3789
Fax Number : 260-436-2703
Provider Business Practice Location Address
First Line : 7910 W JEFFERSON BLVD
Second Line : STE 201
City : FORT WAYNE
State : IN
Zip : 46804-4159
Country : US
Telephone Number : 260-436-3789
Fax Number : 260-436-2703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 04/22/2008

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Directions to “ DR. AARON J SACKETT MD” Practice Location

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