Healthcare Provider Details

I. General information

NPI: 1477846459
Provider Name (Legal Business Name): BENJAMIN JOSEPH SLOOP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 GATEWAY STE 100B
MASON OH
45040-1890
US

IV. Provider business mailing address

401 W EADS PKWY STE 320
LAWRENCEBURG IN
47025-1374
US

V. Phone/Fax

Practice location:
  • Phone: 513-229-7800
  • Fax: 513-229-7888
Mailing address:
  • Phone: 812-539-2900
  • Fax: 812-539-2999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number48040
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number48040
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number48040
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: