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General NPI Number Information
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NPI Number | 1629011994
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Entity Type | Organization
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Legal Business Name | BEN L. SHORT, M.D., LLC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1230 E 6TH AVE SUITE 2B
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City | WINFIELD
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State | KS
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Zip | 67156-3143
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Country | US
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Telephone | 620-221-7669
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Fax | 620-221-7609
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Provider Business Mailing Address
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Address Line | 1230 E 6TH AVE SUITE 2B
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City | WINFIELD
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State | KS
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Zip | 67156-3143
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Country | US
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Telephone | 620-221-7669
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Fax | 620-221-7609
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Authorized Official
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Title or Position | PRESIDENT
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Name | BEN LEE SHORT
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Credential | M.D.
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Telephone | 620-221-7669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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