Provider Demographics
NPI:1912437146
Name:TAI, AARON JUSTIN (OD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:JUSTIN
Last Name:TAI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:10967 ALLISONVILLE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2634
Mailing Address - Country:US
Mailing Address - Phone:317-577-0707
Mailing Address - Fax:317-577-1567
Practice Address - Street 1:10967 ALLISONVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038
Practice Address - Country:US
Practice Address - Phone:317-577-0707
Practice Address - Fax:317-577-1567
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004020A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty