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General NPI Number Information
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NPI Number | 1164955308
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Entity Type | Individual
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Provider Name | BENJAMIN PALMER DPM
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Gender | Male
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 135 CHESAPEAKE LANE 104
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City | CLARKSVILLE
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State | TN
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Zip | 37040
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Country | US
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Telephone | 931-245-1920
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Fax | 931-245-1928
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Provider Business Mailing Address
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Address Line | 135 CHESAPEAKE LANE 104
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City | CLARKSVILLE
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State | TN
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Zip | 37040
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Country | US
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Telephone | 931-245-1920
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Fax | 931-245-1928
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 935
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 283247
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License Number State | KY
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