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General NPI Number Information
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NPI Number | 1942825567
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Entity Type | Individual
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Provider Name | BENJAMIN FACER MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 4003 KRESGE WAY STE 115
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City | LOUISVILLE
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State | KY
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Zip | 40207-4652
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Country | US
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Telephone | 502-897-8163
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Fax | 502-928-8919
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Provider Business Mailing Address
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Address Line | 1901 CAMPUS PL
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City | LOUISVILLE
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State | KY
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Zip | 40299-2308
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Country | US
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Telephone | 502-253-4924
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Fax | 502-489-5750
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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 | 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 #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 60838
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License Number State | KY
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