Provider Demographics
NPI:1104832450
Name:ESBENSHADE, AARON M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:M
Last Name:ESBENSHADE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 CENTRAL PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3494
Mailing Address - Country:US
Mailing Address - Phone:615-883-9781
Mailing Address - Fax:615-872-9215
Practice Address - Street 1:3810 CENTRAL PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3494
Practice Address - Country:US
Practice Address - Phone:615-883-9781
Practice Address - Fax:615-872-9215
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000011346174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB59468Medicare UPIN
TN3186327Medicare PIN