Provider Demographics
NPI:1124242193
Name:AIKEN, MICHAEL M (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:AIKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W BROW RD
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37350-1115
Mailing Address - Country:US
Mailing Address - Phone:423-267-5003
Mailing Address - Fax:423-265-5680
Practice Address - Street 1:501 W BROW RD
Practice Address - Street 2:
Practice Address - City:LOOKOUT MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37350-1115
Practice Address - Country:US
Practice Address - Phone:423-267-5003
Practice Address - Fax:423-265-5680
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000012779208D00000X
GA022204208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice