Provider Demographics
NPI:1255478996
Name:BARKLEY, AARON THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:THOMAS
Last Name:BARKLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4337 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-5504
Mailing Address - Country:US
Mailing Address - Phone:614-472-2220
Mailing Address - Fax:614-472-2221
Practice Address - Street 1:4337 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-5504
Practice Address - Country:US
Practice Address - Phone:614-472-2220
Practice Address - Fax:614-472-2221
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300205001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2212886Medicaid