BENJAMIN DAVID INGRAM (NPI# 1750611216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750611216 |
| Entity Type | Individual |
| Full Name | BENJAMIN DAVID INGRAM |
| Credential | PA |
| Practice Address |
307 Boatner Rd Suite 114 Eglin Afb FL 32542-1282 |
| Practice Telephone | 8508834677 |
| Practice Fax Number | 8508839702 |
| Mailing Telephone | 8508834677 |
| Mailing Fax Number | 8508839702 |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2010-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538291042 | Benjamin James Ingram | Family Medicine | 623 Gettysburg, Building 623, Tower Barracks Grafenwoehr, BAVARIA 92655 | 2007-03-10 |
| 1356301485 | Benjamin Derrick Ingram | Optometrist | 4406-a Forest Drive, Suite 1, Columbia, SC 29206 | 2006-03-24 |
| 1376539536 | Benjamin B Ingram | Dentist | 207 Rome Ave, Piedmont, AL 36272-1919 | 2005-09-23 |
| 1578086468 | Benjamin Ingram | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2017-07-21 |
| Street Address |
307 BOATNER RD SUITE 114 |
| City | EGLIN AFB |
| State | FL |
| Zip Code | 32542-1282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083618987 | Clarence E Pearson | Internal Medicine | 307 Boatner Rd, Suite 114, Eglin Afb, FL 32542-1302 | 2005-06-08 |
| 1821600024 | David George Morrison Jr. | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-08-19 |
| 1679185250 | Peter Andrew Watters | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-08-17 |
| 1558981365 | Kassandra Martinez-campos | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-04-22 |
| 1023638830 | Chanute Lockhart | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-04-22 |
| 1801434964 | Bryan Meek | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-12-19 |
| 1710525936 | Kaitlin Dickson | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-12-18 |
| 1376186213 | Kayle Elizabeth Southerland | Military Health Care Provider | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-10-23 |
| 1902452063 | Justin Michael Rhoads | Pharmacist | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-08-14 |
| 1295389609 | Joseph Clarence Smith Jr. | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542 | 2019-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417440306 | Colt Sicher | Student in an Organized Health Care Education/Training Program | 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 | 2018-06-14 |
| 1841679529 | Matthew Scurria | Dentist | 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 | 2015-05-27 |
| 1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
| 1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
| 1548602923 | Gerald Jordan Novack | Psychologist | 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 | 2013-07-25 |
| 1699112821 | Taylor Anne Hahn | Obstetrics & Gynecology | 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 | 2013-05-29 |
| 1730456948 | Nicholas Brandon Sager | Dentist | 340 Boatner Rd, Eglin Afb, Apo, AA 32542 | 2011-11-17 |
| 1134402662 | Jessamy Jae Thornton | Student in an Organized Health Care Education/Training Program | 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 | 2011-09-21 |
| 1346523974 | Mary Elizabeth Sorrentino | Dentist | 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 | 2011-09-20 |
| 1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
| Find all providers in zip 32542 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598155350 | Ryan Seymour | Physician Assistant | 96 Boatner Dr, Eglin Afb, FL 32542-1319 | 2015-02-02 |
| 1982786380 | Kyle Gene Cooper | Physician Assistant | 6069 Walkers Ln, Eglin Afb, FL 32542-8505 | 2006-10-19 |
| 1821600024 | David George Morrison Jr. | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-08-19 |
| 1679185250 | Peter Andrew Watters | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-08-17 |
| 1558981365 | Kassandra Martinez-campos | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-04-22 |
| 1023638830 | Chanute Lockhart | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-04-22 |
| 1801434964 | Bryan Meek | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-12-19 |
| 1710525936 | Kaitlin Dickson | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-12-18 |
| 1295389609 | Joseph Clarence Smith Jr. | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542 | 2019-07-25 |
| 1568015105 | Kylie Hamilton | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-07-23 |
| Find all providers in EGLIN AFB | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.