Provider Demographics
NPI:1558481358
Name:BENJAMIN, CYRIL PHILIP (DC)
Entity Type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:PHILIP
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 CHANCELLOR DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3912
Mailing Address - Country:US
Mailing Address - Phone:859-491-8300
Mailing Address - Fax:859-491-9649
Practice Address - Street 1:2865 CHANCELLOR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3912
Practice Address - Country:US
Practice Address - Phone:859-491-8300
Practice Address - Fax:859-491-9649
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8500187300Medicaid
KY8500187300Medicaid