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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356301485 NPPES
South Carolina MEDICAID D13206

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