Dr. Aaron J Prussin
Otolaryngologist (ENT Doctor) Plastic Surgeon (Head & Neck)
830 Davis St Suite 1
Blacksburg
, Virginia 24060-7010
Dr. Aaron J Prussin
Otolaryngologist (ENT Doctor) Plastic Surgeon (Head & Neck)
830 Davis St Suite 1
Blacksburg
, Virginia 24060-7010
(801) 715-8228
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Dr. Aaron J Prussin
- 127 S. 500 E Suite 600
- Salt Lake City, UT
- Zip : 84102-1971
- Fax : (801) 715-8228
- Phone : (801) 587-6336
Second Address
- Dr. Aaron J Prussin
- 830 Davis St Suite 1
- Blacksburg, VA
- Zip : 24060-7010
- Fax : (540) 381-1462
- Phone : (540) 381-0344
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | FP5290337 | UT |
| N | 207YX0007X | Plastic Surgeon (Head & Neck) | 0101051964 | VA |
National Provider Identifier
| NPI | 1609867266 |
|---|---|
| Provider Name | Dr. Aaron J Prussin |
| First Address | Salt Lake City, UT 84102-1971 |
| Second Address | Blacksburg, VA 24060-7010 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/11/2005 |
| Last Update Date | 12/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 006500111 | (05) | VA |
| 006500111 | VIRGINIA PREMIER (01) | VA |
| 018759S56 | MEDICARE INDIVIDUAL PTAN (01) | VA |
| 1000460 | UNITED HEALTHCARE (01) | VA |
| 127380 | SOUTHERN HEALTH (01) | VA |
| 140176 | ANTHEM (01) | VA |
| 140176 | VIRGINIA HEALTHKEEPERS (01) | VA |
| 1609867266 | (05) | VA |
| 332829 | MAMSI (01) | VA |
| 541982275 | JOHN DEERE (01) | VA |
| 541982275 | VIRGINIA HEALTH NETWORK (01) | VA |
| 5860049 | AETNA US HEALTHCARE (01) | VA |
| 6566060005 | CIGNA (01) | VA |
| A2283 | MEDCOST (01) | VA |
| C06556 | MEDICARE GROUP PTAN (01) | VA |
| C06637 | MEDICARE GROUP # (01) | VA |
| C09521 | MEDICARE GROUP PTAN (01) | VA |
| E68557 | (02) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.