Healthcare Provider Details

I. General information

NPI: 1063049583
Provider Name (Legal Business Name): BENJAMIN CHRISTOPHER FORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE STE 1400
ATLANTA GA
30308-2241
US

IV. Provider business mailing address

550 PEACHTREE ST NE STE 1400
ATLANTA GA
30308-2241
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-7178
  • Fax: 404-251-2726
Mailing address:
  • Phone: 404-778-7178
  • Fax: 404-251-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number110923
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: