Back, Ben W
Back, Ben W is an individual health care provider with primary practice located at 210 Black Gold Blvd Ste 106 , Hazard KY 41701-2620. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Back, Ben W can be contacted via phone (606) 436-0711.Contact Information
Primary practice address
210 Black Gold Blvd Ste 106
Hazard KY 41701-2620
Phone: (606) 436-0711
Fax: (606) 436-0848
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA364 | Kentucky |
Profile Details
| NPI number | 1619942562 |
|---|---|
| LBN Legal business name | Back, Ben W |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | May 13th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619942562 | NPPES |
| Kentucky | MEDICAID | 95000287 |
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