Provider Demographics
NPI:1972503985
Name:AARON, JOHN WENDEL III (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WENDEL
Last Name:AARON
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 DEWAR DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5851
Mailing Address - Country:US
Mailing Address - Phone:307-382-3257
Mailing Address - Fax:307-382-2296
Practice Address - Street 1:1471 DEWAR DR
Practice Address - Street 2:SUITE 112
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5851
Practice Address - Country:US
Practice Address - Phone:307-382-3257
Practice Address - Fax:307-382-2296
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY72213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY302477OtherBLUE CROSS BLUE SHIELD
WY302477Medicare ID - Type UnspecifiedMEDICARE NUMBER
WY302477OtherBLUE CROSS BLUE SHIELD