Provider Demographics
NPI:1992185094
Name:TAUER, AARON (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:TAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 LAKE OTIS PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5231
Mailing Address - Country:US
Mailing Address - Phone:907-563-4810
Mailing Address - Fax:907-563-4811
Practice Address - Street 1:4100 LAKE OTIS PKWY STE 320
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5231
Practice Address - Country:US
Practice Address - Phone:907-563-4810
Practice Address - Fax:907-563-4811
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO25000279402084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2015015407OtherMISSOURI TEMPORARY LICENSE