Provider Demographics
NPI:1528005865
Name:AARON, JANNICE OWENS (MD)
Entity Type:Individual
Prefix:
First Name:JANNICE
Middle Name:OWENS
Last Name:AARON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E ADAMS ST
Mailing Address - Street 2:STE 4
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-1278
Mailing Address - Country:US
Mailing Address - Phone:502-222-3281
Mailing Address - Fax:502-225-5796
Practice Address - Street 1:120 E ADAMS ST
Practice Address - Street 2:STE 4
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-1278
Practice Address - Country:US
Practice Address - Phone:502-222-3281
Practice Address - Fax:502-225-5796
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY197032085R0202X, 2085B0100X, 2085N0700X, 2085U0001X, 2085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64197031Medicaid
KY64197031Medicaid
KY0518501Medicare ID - Type UnspecifiedSOUTH CENTRAL KY OPEN MRI
KY00195001Medicare PIN
KY0665502Medicare ID - Type UnspecifiedJANE TODD HOSP.RAD.ASSOC.
KY0691701Medicare ID - Type UnspecifiedHARDIN CO. IMAGING
IN215510AMedicare ID - Type UnspecifiedPERRY CO. RAD.ASSOC.
KYD20633Medicare UPIN
KY0913303Medicare ID - Type UnspecifiedPERRY CO. RADIOLOGICAL