Healthcare Provider Details

I. General information

NPI: 1497955751
Provider Name (Legal Business Name): BENJAMIN PODIATRY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 08/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2667 FOX POINTE DR
COLUMBUS IN
47203
US

IV. Provider business mailing address

2667 FOX POINTE DR
COLUMBUS IN
47203-3222
US

V. Phone/Fax

Practice location:
  • Phone: 812-378-5800
  • Fax: 812-378-5808
Mailing address:
  • Phone: 812-378-5800
  • Fax: 812-378-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number07000853A
License Number StateIN

VIII. Authorized Official

Name: DR. SCOTT M BENJAMIN
Title or Position: PRESIDENT
Credential: DPM
Phone: 812-378-5800