Baccus, John Benjamin
Baccus, John Benjamin is an individual health care provider with primary practice located at 500 Arcade Ave Ste 200 , Elkhart IN 46514-2485. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Baccus, John Benjamin can be contacted via phone (574) 294-8404.Contact Information
Primary practice address
500 Arcade Ave Ste 200
Elkhart IN 46514-2485
Phone: (574) 294-8404
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 01072136A | Indiana |
Profile Details
NPI number | 1508831157 |
---|---|
LBN Legal business name | Baccus, John Benjamin |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 17th, 2006 |
Last updated | Apr 28th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1508831157 | NPPES |
Indiana | MEDICAID | 201141150 |
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