Provider Demographics
NPI:1770602294
Name:AARON R WILMES OD PA
Entity type:Organization
Organization Name:AARON R WILMES OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-841-2500
Mailing Address - Street 1:PO BOX 3471
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-0471
Mailing Address - Country:US
Mailing Address - Phone:785-841-2500
Mailing Address - Fax:785-838-9444
Practice Address - Street 1:3201 IOWA ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-5205
Practice Address - Country:US
Practice Address - Phone:785-841-2500
Practice Address - Fax:785-838-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1698152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSV01507Medicare UPIN
KS065113Medicare PIN