Healthcare Provider Details

I. General information

NPI: 1124025564
Provider Name (Legal Business Name): SCOTT MCCLARREN BENJAMIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1159 W JEFFERSON ST
FRANKLIN IN
46131-2794
US

IV. Provider business mailing address

1159 W JEFFERSON ST
FRANKLIN IN
46131-2794
US

V. Phone/Fax

Practice location:
  • Phone: 317-346-3913
  • Fax: 317-346-3001
Mailing address:
  • Phone: 317-346-3913
  • Fax: 812-378-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number07000853A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07000853A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: