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NPI Code Detail

MEDICARE: DR. BENJAMIN ALLEN CLOUSE MD

MEDICARE: DR. BENJAMIN ALLEN CLOUSE MD
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
1207Q00000XFamily Medicine Physician35.153850OH

General Provider Information

NPI Number : 1194466516
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN ALLEN CLOUSE MD
Provider Business Mailing Address
First Line : 2261 PHILADELPHIA DR STE 300
Second Line :
City : DAYTON
State : OH
Zip : 45406-1814
Country : US
Telephone Number : 937-734-4141
Fax Number :
Provider Business Practice Location Address
First Line : 2261 PHILADELPHIA DR STE 300
Second Line :
City : DAYTON
State : OH
Zip : 45406-1814
Country : US
Telephone Number : 937-734-4141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2022
Last Update Date : 04/20/2026

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