Provider Demographics
NPI:1114187416
Name:PITMAN, BENJAMIN D (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:D
Last Name:PITMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 840848
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0848
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-9976
Practice Address - Street 1:1200 NE 13TH
Practice Address - Street 2:OKLA. COUNTY CRISIS INTERVENTION CENTER
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73152
Practice Address - Country:US
Practice Address - Phone:405-522-8150
Practice Address - Fax:405-522-4120
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK263312084P0800X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry