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General NPI Number Information
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NPI Number | 1962080432
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Entity Type | Individual
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Provider Name | BENJAMIN DAVID REISWIG DO
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Gender | Male
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1105 SUNSET AVE
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City | MANHATTAN
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State | KS
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Zip | 66502-3739
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Country | US
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Telephone | 785-532-6544
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Fax |
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Provider Business Mailing Address
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Address Line | 1317 OVERLOOK DR
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City | MANHATTAN
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State | KS
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Zip | 66503-2573
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Country | US
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Telephone | 316-516-8187
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0070132
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License Number State | CO
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