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NPI Code Detail

MEDICARE: DR. BENJAMIN HARRIS DO

MEDICARE: DR. BENJAMIN HARRIS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician2017005303MO
2207R00000XInternal Medicine Physician2017005303MO

General Provider Information

NPI Number : 1093125080
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN HARRIS DO
Provider Business Mailing Address
First Line : 608 CATHERINE CT
Second Line :
City : FREEBURG
State : IL
Zip : 62243-1631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7777 BONHOMME AVE STE 1800
Second Line :
City : CLAYTON
State : MO
Zip : 63105-1931
Country : US
Telephone Number : 855-229-2177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2014
Last Update Date : 05/05/2025

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