Ingram, Benjamin Derrick
Ingram, Benjamin Derrick is an individual health care provider with primary practice located at 4406-A Forest Drive Suite 1, Columbia SC 29206. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ingram, Benjamin Derrick can be contacted via phone (803) 782-7080.Contact Information
Primary practice address
4406-A Forest Drive Suite 1
Columbia SC 29206
Phone: (803) 782-7080
Fax: (803) 744-0964
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1320 | South Carolina |
Profile Details
| NPI number | 1356301485 |
|---|---|
| LBN Legal business name | Ingram, Benjamin Derrick |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1356301485 | NPPES |
| South Carolina | MEDICAID | D13206 |
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