Basic Information
Provider Information
NPI: 1750736997
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURKET
FirstName: AARON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 1501 N CAMPBELL AVE RM 4303
Address2: PO BOX 245070
City: TUCSON
State: AZ
PostalCode: 85724
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1501 N CAMPBELL AVE RM 4334
Address2:  
City: TUCSON
State: AZ
PostalCode: 857245058
CountryCode: US
TelephoneNumber: 5206267747
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/25/2016
LastUpdateDate: 05/19/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000XR2646AZY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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