MEDICARE: DR. BENJAMIN SCOTT ENGLAND PT, DPT, CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	05013330A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05013330A	OTHER	IN	PT LICENSE

General Provider Information

NPI Number	:	1053977355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN SCOTT ENGLAND PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	1775 BRECKENRIDGE PASS
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-8666
Country	:	US
Telephone Number	:	740-403-9133
Fax Number	:

Provider Business Practice Location Address
First Line	:	12912 COLDWATER RD STE 9C
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-8870
Country	:	US
Telephone Number	:	260-739-0300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2019
Last Update Date	:	05/13/2019

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