Individual
AARON NEWCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 S LEWIS LANE, CARBONDALE, IL 62901-3021
(618) 519-9900
(618) 519-9901
Mailing address
PO BOX 577, CARTERVILLE, IL 62918-0577
(618) 985-8221
(618) 985-6860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036119399
IL
207QA0401X
Addiction Medicine (Family Medicine) Physician
036119399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10032052
BCBS
IL
01
—
1639295314
SHAWNEE HEALTH SERVICE NP
IL
05
—
370966854002
—
IL
05
—
370966854005
—
IL
05
—
370966854006
—
IL
01
—
640701
MEDICARE PART B GROUP NUMBER
IL
01
—
CF3444
MEDICARE RAILROAD
IL
Enumeration date
04/22/2008
Last updated
10/01/2024
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