Provider Demographics
NPI:1285759548
Name:WAITE, AARON N (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:N
Last Name:WAITE
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 1:3333 N DIGITAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6694
Mailing Address - Country:US
Mailing Address - Phone:801-876-6000
Mailing Address - Fax:
Practice Address - Street 1:3333 N DIGITAL DR STE 300
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6694
Practice Address - Country:US
Practice Address - Phone:801-876-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13806207W00000X
TN49248207W00000X
CO48578207W00000X
UT10314201-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I186647OtherMEDICARE
MS00533051Medicaid
CO55238289Medicaid
AR198289001Medicaid
CO55238289Medicaid