Provider Demographics
NPI:1093061210
Name:LEATHERMAN, AARON (PA)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:LEATHERMAN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:PRISCILLA PAYNE HURD PAVILION, SECOND FLOOR
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-1735
Mailing Address - Fax:484-526-2429
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:PRISCILLA PAYNE HURD PAVILION, SECOND FLOOR
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-1735
Practice Address - Fax:484-526-2429
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA055631363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant