Provider Demographics
NPI:1245610955
Name:THRASHER, AARON M (MHS, PA-C)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:M
Last Name:THRASHER
Suffix:
Gender:M
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 LAKE OTIS PARKWAY SUITE 200
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-563-4810
Mailing Address - Fax:907-563-4811
Practice Address - Street 1:4100 LAKE OTIS PARKWAY SUITE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-563-4810
Practice Address - Fax:907-563-4811
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100127363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1630721Medicaid