Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 05950 | MS |
NPI | 1669697801 |
---|---|
Provider Name | Dr. William Lelon Aron JR. |
First Address | Jackson, MS 39211-1801 |
Second Address | Jackson, MS 39211-1801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2007 |
Last Update Date | 09/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0122345 | (05) | MS |
B30254 | (02) | MS |