Provider Demographics
NPI:1346456563
Name:BENJAMIN O. STILES, D.C., P.C.
Entity Type:Organization
Organization Name:BENJAMIN O. STILES, D.C., P.C.
Other - Org Name:STILES CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:O
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-220-2203
Mailing Address - Street 1:103 SW STATE ROUTE 7
Mailing Address - Street 2:SUITE H
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-3047
Mailing Address - Country:US
Mailing Address - Phone:816-220-2203
Mailing Address - Fax:816-220-2321
Practice Address - Street 1:103 SW STATE ROUTE 7
Practice Address - Street 2:SUITE H
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-3047
Practice Address - Country:US
Practice Address - Phone:816-220-2203
Practice Address - Fax:816-220-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOM57B889Medicare ID - Type UnspecifiedPROVIDER
MOU90906Medicare UPIN
MOM570000Medicare ID - Type UnspecifiedGROUP