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General NPI Number Information
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NPI Number | 1104716232
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Entity Type | Individual
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Provider Name | BENJAMIN ENK
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Gender | Male
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1609 POPLAR LEVEL RD
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City | LOUISVILLE
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State | KY
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Zip | 40217-1359
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Country | US
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Telephone | 502-637-4712
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Fax |
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Provider Business Mailing Address
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Address Line | 4320 CARA WAY
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City | LOUISVILLE
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State | KY
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Zip | 40299-4095
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Country | US
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Telephone | 414-617-7997
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Fax | 414-617-7997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 1689
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License Number State | KY
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