Basic Information
Provider Information
NPI: 1457686917
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HONEYCUTT
FirstName: AARON
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 CORPORATE DR STE 400
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352425424
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 4232383473
Practice Location
Address1: 1275 HIGHWAY 54 W
Address2: SUITE 200
City: FAYETTEVILLE
State: GA
PostalCode: 302144549
CountryCode: US
TelephoneNumber: 7704608609
FaxNumber: 7704608629
Other Information
ProviderEnumerationDate: 10/16/2009
LastUpdateDate: 07/21/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/21/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT009792GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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