Provider Demographics
NPI:1114983871
Name:SPALDING, AARON C (MD PHD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:C
Last Name:SPALDING
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3700
Mailing Address - Country:US
Mailing Address - Phone:502-629-2500
Mailing Address - Fax:502-629-2055
Practice Address - Street 1:4001 DUTCHMANS LANE
Practice Address - Street 2:SUITE G02
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-899-6601
Practice Address - Fax:502-899-6630
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059740A207R00000X
MI43010818062085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY710067120Medicaid
KY50022085OtherPASSPORT
IN200508490Medicaid
IN129980HHMedicare UPIN
KY0299049Medicare UPIN
KY50022085OtherPASSPORT