Provider Demographics
NPI:1386885267
Name:BURKS, AARON (AUD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BURKS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4198 DARR RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-9530
Mailing Address - Country:US
Mailing Address - Phone:419-939-3186
Mailing Address - Fax:419-992-1090
Practice Address - Street 1:8153 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OLD FORT
Practice Address - State:OH
Practice Address - Zip Code:44861-9800
Practice Address - Country:US
Practice Address - Phone:419-939-3186
Practice Address - Fax:419-992-1090
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01667231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist