Provider Demographics
NPI:1497741102
Name:YOUNTS, BENJAMIN LWW (DO)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LWW
Last Name:YOUNTS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 N VAN BUREN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SHIPSHEWANA
Mailing Address - State:IN
Mailing Address - Zip Code:46565-8702
Mailing Address - Country:US
Mailing Address - Phone:260-768-4061
Mailing Address - Fax:
Practice Address - Street 1:935 N VAN BUREN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SHIPSHEWANA
Practice Address - State:IN
Practice Address - Zip Code:46565-8702
Practice Address - Country:US
Practice Address - Phone:260-768-4061
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001953A111N00000X
MIL557714111N00000X
IN81000026A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000185999OtherBLUE CROSS
IN000000185999OtherBLUE CROSS
INU83508Medicare UPIN