MEDICARE: DR. BENJAMIN LEE GARLAND O.D.

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	152W00000X	Optometrist	18002690	IN

General Provider Information

NPI Number	:	1235132929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN LEE GARLAND O.D.

Provider Business Mailing Address
First Line	:	1033 E MOUNT PLEASANT RD
Second Line	:	STE B
City	:	EVANSVILLE
State	:	IN
Zip	:	47725-7149
Country	:	US
Telephone Number	:	812-401-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	1033 E MOUNT PLEASANT RD
Second Line	:	STE B
City	:	EVANSVILLE
State	:	IN
Zip	:	47725-7149
Country	:	US
Telephone Number	:	812-437-2020
Fax Number	:

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	11/06/2024

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