Provider Demographics
NPI:1235132929
Name:GARLAND, BENJAMIN LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LEE
Last Name:GARLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 E MOUNT PLEASANT RD
Mailing Address - Street 2:STE B
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-7149
Mailing Address - Country:US
Mailing Address - Phone:812-401-1010
Mailing Address - Fax:
Practice Address - Street 1:1033 E MOUNT PLEASANT RD
Practice Address - Street 2:STE B
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-7149
Practice Address - Country:US
Practice Address - Phone:812-437-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002690152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU50618Medicare UPIN