Provider Demographics
NPI:1437371721
Name:YOUNG, BENJAMIN DAVIES (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:DAVIES
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3405
Mailing Address - Country:US
Mailing Address - Phone:316-630-9300
Mailing Address - Fax:316-262-4887
Practice Address - Street 1:12112 W KELLOGG ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67235
Practice Address - Country:US
Practice Address - Phone:316-630-9300
Practice Address - Fax:316-440-1089
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27270207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery