Virgil Isaac Aultman, MD

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

06153 Issued in MS

Practice address

2747 Old Canton Rd
Jackson, MS 39216-4308

Phone

(601) 366-6452

Fax

(601) 366-6488

NPI assigned

Jul 11, 2005

Last updated

Mar 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1922006279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2747 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164308",
            "telephone_number": "601-366-6452",
            "fax_number": "601-366-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164308",
            "telephone_number": "601-366-6452",
            "fax_number": "601-366-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULTMAN",
        "first_name": "VIRGIL",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MS",
            "license": "06153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00013576",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Y Atkinson, RPT
• Atlascare ABA Ms LLC
• Roya Attar, O.D
• Nobel Dzorgbenyah Attipoe, MD
• Amanda Wynne Atwood, CFNP
• Hallie Austin
• James B Austin, PH.D.
• Jamie M Austin, OTR/L
• Louise Austin
• Marsha Lynn Austin, FNP-BC

• Adult Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Adult Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.