Provider Demographics
NPI:1689014227
Name:BANKS, AARON PARKER (DO)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:PARKER
Last Name:BANKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:KY
Mailing Address - Zip Code:41171-0748
Mailing Address - Country:US
Mailing Address - Phone:606-738-5155
Mailing Address - Fax:606-738-5420
Practice Address - Street 1:390 KY HIGHWAY 7 S
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:KY
Practice Address - Zip Code:41171-0748
Practice Address - Country:US
Practice Address - Phone:606-738-5155
Practice Address - Fax:606-738-5420
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP206207Q00000X
390200000X
KY04013207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY04013OtherMEDICAL LICENSE
KY7100383190Medicaid
KY49942070Medicare PIN
KYK188473Medicare PIN