person
Ben W Back, PA
Medical Physician Assistant in Hazard, Kentucky
NPI 1619942562

Ben W Back is a Medical Physician Assistant based in Hazard, KY and is specialized in Medical. Ben W Back practices in Hazard, KY and has the professional credentials of PA. The NPI Number for Ben W Back is 1619942562 and holds a License No. PA364 (Kentucky).

The current practice location address for Ben W Back is 210 Black Gold Blvd Ste 106, Hazard, KY and can be reached out via phone at 606-436-0711 and via fax at 606-436-0848.

Location: 210 Black Gold Blvd Ste 106, Hazard, KY, 41702-0959
person
Provider Profile Details
NPI Number
1619942562
Provider Name
Ben W Back
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
210 Black Gold Blvd Ste 106, Hazard, KY, 41702-0959
Phone Number
606-436-0711
Fax Number
606-436-0848
Provider Enumeration Date
02/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
95000287 05 KY
institution
Provider Business Practice Location Address Details
Address
210 Black Gold Blvd Ste 106
City
State
Zip
41701-2620
Phone Number
606-436-0711
Fax Number
606-436-0848
person
Provider Business Mailing Address Details
Address
210 Black Gold Blvd Ste 106
City
State
Zip
41701-2620
Phone Number
606-436-0711
Fax Number
606-436-0848
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA364 (Kentucky)
Definition
Definition to come...
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