Provider Demographics
NPI:1952466732
Name:WARNER, AARON M (OD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:M
Last Name:WARNER
Suffix:
Gender:M
Credentials:OD
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Other - First Name:
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Mailing Address - Street 1:1642 OLIVE BRANCH PARKE LN
Mailing Address - Street 2:SUITE1000
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9821
Mailing Address - Country:US
Mailing Address - Phone:317-883-0071
Mailing Address - Fax:317-300-1678
Practice Address - Street 1:1642 OLIVE BRANCH PARKE LN # 1000
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9821
Practice Address - Country:US
Practice Address - Phone:317-883-0071
Practice Address - Fax:317-883-0071
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003007152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0873400007Medicare NSC
IN187400BMedicare PIN