Boardman, Benjamin Jelinek

Boardman, Benjamin Jelinek is an individual health care provider with primary practice located at N6520 Guy Road , Black River Falls WI 54615. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Boardman, Benjamin Jelinek can be contacted via phone (715) 284-9851.

Contact Information

Primary practice address
N6520 Guy Road Black River Falls WI 54615
Phone: (715) 284-9851
Fax: (715) 284-5150
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 39498 Wisconsin

Profile Details

NPI number 1487749396
LBN Legal business name Boardman, Benjamin Jelinek
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487749396 NPPES
Wisconsin Other 80192405 PALMETTO GBA
Wisconsin MEDICAID 32399800 PALMETTO GBA
Wisconsin Other 51470 PALMETTO GBA

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