Provider Demographics
NPI:1760636526
Name:CLARE, AARON TIMOTHY (PA-C)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:TIMOTHY
Last Name:CLARE
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 1:18444 N 25TH AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1261
Mailing Address - Country:US
Mailing Address - Phone:623-537-5600
Mailing Address - Fax:866-939-2673
Practice Address - Street 1:14520 W GRANITE VALLEY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5855
Practice Address - Country:US
Practice Address - Phone:623-537-5600
Practice Address - Fax:866-939-2673
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4530363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5550830007OtherMEDICARE NSC DV
AZ5550830012OtherMEDICARE NSC SPINE CENTER
AZ5550830001OtherMEDICARE NSC SUN CITY WEST
AZ480271Medicaid
AZ5550830010OtherMEDICARE NSC GILBERT
AZ5550830003OtherMEDICARE NSC PEORIA
AZ5550830011OtherMEDICARE NSC CENTRAL PHOENIX
AZ480271Medicaid