MEDICARE: DR. BENJAMIN FRANKLIN KELM DC

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
1	111N00000X	Chiropractor	4506	OK

General Provider Information

NPI Number	:	1144918921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN FRANKLIN KELM DC

Provider Business Mailing Address
First Line	:	8001 S MINGO RD APT 503
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-0809
Country	:	US
Telephone Number	:	913-991-8170
Fax Number	:

Provider Business Practice Location Address
First Line	:	7329 S OLYMPIA AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74132-1849
Country	:	US
Telephone Number	:	918-233-3993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2023
Last Update Date	:	04/28/2023

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