Tanner, Benjamin D

Tanner, Benjamin D is an individual health care provider with primary practice located at 1000 Dupont Rd , Louisville KY 40207-4611. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Tanner, Benjamin D can be contacted via phone (502) 889-6405.

Contact Information

Primary practice address
1000 Dupont Rd Louisville KY 40207-4611
Phone: (502) 889-6405
Fax: (502) 899-6407
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 33097 Kentucky

Profile Details

NPI number 1649240649
LBN Legal business name Tanner, Benjamin D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jan 22nd, 2021 - about 4 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 1649240649 NPPES
Kentucky Other 110964 SIHO - NHWMS
Kentucky MEDICAID 200518160 SIHO - NHWMS
Kentucky Other 3945283 SIHO - NHWMS
Kentucky Other 50027318 SIHO - NHWMS
Kentucky MEDICAID 64100811 SIHO - NHWMS
Kentucky Other 000000642238 SIHO - NHWMS
Kentucky Other 000052153C SIHO - NHWMS
Kentucky Other 3764333000 SIHO - NHWMS
Kentucky Other 50006995 SIHO - NHWMS

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