Provider Demographics
NPI:1508386418
Name:WILLFORD, BENJAMIN (DO)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:WILLFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8401 S CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9498
Mailing Address - Country:US
Mailing Address - Phone:720-875-2880
Mailing Address - Fax:720-875-2877
Practice Address - Street 1:3205 N ACADEMY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5147
Practice Address - Country:US
Practice Address - Phone:719-632-5700
Practice Address - Fax:719-344-7814
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0064833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine