Provider Demographics
NPI:1407946155
Name:LIND, BEN W (MD)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:W
Last Name:LIND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST #800
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:1380 EAST MEDICAL CENTER DRIVE
Practice Address - Street 2:DIXIE REGIONAL MEDICAL CENTER
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-251-1000
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4985436-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806852600Medicaid
NV100503113Medicaid
UT851448OtherDESERET MUTUAL
UT870545614BWLOtherEDUCATORS MUTUAL
UT107027340101OtherIHC
UTQM0000075886OtherALTIUS
UT1502954OtherUMWA
UT77512OtherPEHP
UTTPRA09319OtherMOLINA
UT49854361200001OtherBCBS
UT99466OtherHEALTHY U
UT2090168OtherUNITED HEALTHCARE
AZ855405Medicaid
UT1502954OtherUMWA
UTI03830Medicare UPIN
UT77512OtherPEHP