Healthcare Provider Details

I. General information

NPI: 1659298990
Provider Name (Legal Business Name): URIAN MARTIN BENICKER PRS, BHPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BENNY BENICKER PRS, BHPP

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2903 S 5TH ST
IRONTON OH
45638-2866
US

IV. Provider business mailing address

2903 S 5TH ST
IRONTON OH
45638-2866
US

V. Phone/Fax

Practice location:
  • Phone: 740-646-6640
  • Fax:
Mailing address:
  • Phone: 740-646-6640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRS.007881
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: