MEDICARE: DR. JACOB AELION M.D.

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
1	174400000X	Specialist	MD0000020050	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1679551501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB AELION M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10776
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38308-0112
Country	:	US
Telephone Number	:	731-664-0002
Fax Number	:	731-664-7958

Provider Business Practice Location Address
First Line	:	371 N PARKWAY
Second Line	:	SUITE 400
City	:	JACKSON
State	:	TN
Zip	:	38305-2891
Country	:	US
Telephone Number	:	731-664-0002
Fax Number	:	731-664-7859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	04/23/2025

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