Provider Demographics
NPI:1770551590
Name:KOLB, AARON JAY (MD, MPH, FACOEM)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:JAY
Last Name:KOLB
Suffix:
Gender:M
Credentials:MD, MPH, FACOEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 GRAMPIAN BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1909
Practice Address - Country:US
Practice Address - Phone:570-320-7444
Practice Address - Fax:570-320-7445
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022245E2083X0100X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA818226OtherFIRST PRIORITY HEALTH
PA1768358OtherUNITEDHEALTHCARE
PA1008912350002Medicaid
PA1431402OtherHIGHMARK BLUE SHIELD
PA7545486OtherAETNA
PA7545486OtherAETNA
PA1431402OtherHIGHMARK BLUE SHIELD
PA040023Medicare PIN
B34100Medicare UPIN