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NPI Code Detail

MEDICARE: AARON NEWCOMB DO

MEDICARE: AARON NEWCOMB DO
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
1207Q00000XFamily Medicine Physician036119399IL
2207QA0401XAddiction Medicine (Family Medicine) Physician036119399IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4CF3444OTHERILMEDICARE RAILROAD
6640701OTHERILMEDICARE PART B GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11639295314OTHERILSHAWNEE HEALTH SERVICE NP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
310032052OTHERILBCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568636470
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON NEWCOMB DO
Provider Business Mailing Address
First Line : PO BOX 577
Second Line :
City : CARTERVILLE
State : IL
Zip : 62918-0577
Country : US
Telephone Number : 618-985-8221
Fax Number : 618-985-6860
Provider Business Practice Location Address
First Line : 400 S LEWIS LANE
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-3021
Country : US
Telephone Number : 618-519-9900
Fax Number : 618-519-9901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2008
Last Update Date : 10/01/2024

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Directions to “ AARON NEWCOMB DO” Practice Location

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