Provider Demographics
NPI:1275889560
Name:BENJAMIN J VELTRI MD PLLC
Entity Type:Organization
Organization Name:BENJAMIN J VELTRI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:VELTRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-789-8720
Mailing Address - Street 1:150 W 100 N
Mailing Address - Street 2:SUITE S102
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2036
Mailing Address - Country:US
Mailing Address - Phone:435-789-8720
Mailing Address - Fax:435-789-8725
Practice Address - Street 1:150 W 100 N
Practice Address - Street 2:SUITE S102
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2036
Practice Address - Country:US
Practice Address - Phone:435-789-8720
Practice Address - Fax:435-789-8725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty