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General NPI Number Information
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NPI Number | 1518386242
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Entity Type | Individual
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Provider Name | BENJAMIN INGRAHAM DO
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Gender | Male
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 3425 S CLARKSON ST
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2811
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Country | US
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Telephone | 303-789-8220
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Fax | 303-789-8470
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Provider Business Mailing Address
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Address Line | 3425 S CLARKSON ST
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2811
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Country | US
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Telephone | 303-780-8220
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Fax | 303-789-8470
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 11275969-1204
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 125-064513
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License Number State | IL
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Taxonomy #3
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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 #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 67909
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License Number State | CO
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