Provider Demographics
NPI:1518120617
Name:AARON J. HUPMAN,M.D.,P.C.
Entity Type:Organization
Organization Name:AARON J. HUPMAN,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-925-4200
Mailing Address - Street 1:354 ARCADO RD NW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:354 ARCADO RD NW
Practice Address - Street 2:SUITE 1
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2844
Practice Address - Country:US
Practice Address - Phone:770-925-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021523261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
D29822Medicare UPIN
268505643BMedicare PIN