Individual
AARON D GEORGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4123 DUTCHMAN'S LANE, STE. 401, LOUISVILLE, KY 40207-4733
(502) 394-6341
(502) 394-6340
Mailing address
PO BOX 766351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
PA692
KY
363AS0400X
Surgical Physician Assistant
PA692
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000507776
ANTHEM -CTS
—
01
—
085460
SIHO - CTS
—
01
—
2838725000
PAD - CTS 560
—
01
—
50014981
PASSPORT - CTS 560
—
01
—
50030383
PASSPORT- NOTC
KY
05
—
95001962
—
KY
01
—
P00394137
RRMCR - CTS
KY
Enumeration date
01/17/2007
Last updated
07/21/2016
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