Basic Information
Provider Information
NPI: 1083750681
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: AARON
MiddleName: LEE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 432
Address2:  
City: PIKEVILLE
State: KY
PostalCode: 415020432
CountryCode: US
TelephoneNumber: 6064302206
FaxNumber: 6062187506
Practice Location
Address1: 911 BYPASS RD BLDG A
Address2:  
City: PIKEVILLE
State: KY
PostalCode: 415011689
CountryCode: US
TelephoneNumber: 6064302206
FaxNumber: 6062187506
Other Information
ProviderEnumerationDate: 01/30/2007
LastUpdateDate: 07/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0102X23639WVN Allopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
2086S0102X46179KYY Allopathic & Osteopathic PhysiciansSurgerySurgical Critical Care

ID Information
IDTypeStateIssuerDescription
6412603005KY MEDICAID


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