Dillard, Benjamin Clark

Dillard, Benjamin Clark is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as his primary health care specialty. Dillard, Benjamin Clark can be contacted via phone (601) 984-2000.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 15975 Mississippi

Profile Details

NPI number 1639106636
LBN Legal business name Dillard, Benjamin Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jun 14th, 2012 - about 13 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 1639106636 NPPES
Mississippi MEDICAID 00839845
Mississippi Other 370000378

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