Dastrup, Benjamin T

Dastrup, Benjamin T is an individual health care provider with primary practice located at 875 Country Hills Dr , Ogden UT 84403-2200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Dastrup, Benjamin T can be contacted via phone (801) 399-1149.

Contact Information

Primary practice address
875 Country Hills Dr Ogden UT 84403-2200
Phone: (801) 399-1149
Fax: (801) 394-4481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01062307 Indiana
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 5484681 Utah

Profile Details

NPI number 1073797809
LBN Legal business name Dastrup, Benjamin T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2007
Last updated Jun 26th, 2012 - about 12 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 1073797809 NPPES
Utah MEDICAID 1073797809
Utah Other 000069325

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