MEDICARE: BENJAMIN ALLUMBAUGH PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1558943126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN ALLUMBAUGH PA-C

Provider Business Mailing Address
First Line	:	3406 ALDER AVE
Second Line	:
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703
Country	:	US
Telephone Number	:	907-353-3056
Fax Number	:

Provider Business Practice Location Address
First Line	:	3406 ALDER AVE
Second Line	:
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703
Country	:	US
Telephone Number	:	907-353-3056
Fax Number	:

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

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	03/12/2026

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