Provider Demographics
NPI:1265453831
Name:EGBERT, AARON L (PA-C)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:L
Last Name:EGBERT
Suffix:
Gender:M
Credentials: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:MERCY CARDIOTHORACIC AND VASCULAR CLINIC
Mailing Address - Street 2:788 8TH AVENUE SE, SUITE 300
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401
Mailing Address - Country:US
Mailing Address - Phone:319-861-7200
Mailing Address - Fax:319-861-7201
Practice Address - Street 1:MERCY CARDIOTHORACIC AND VASCULAR CLINIC
Practice Address - Street 2:788 8TH AVENUE SE, SUITE 300
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401
Practice Address - Country:US
Practice Address - Phone:319-861-7200
Practice Address - Fax:319-861-7201
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0281PA363AS0400X
IA001373363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0281PAMedicaid
SC0281PAMedicaid