Provider Demographics
NPI:1578897039
Name:BENJAMIN CHEEK MD LLC
Entity Type:Organization
Organization Name:BENJAMIN CHEEK MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHEEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-660-4908
Mailing Address - Street 1:2000 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8927
Mailing Address - Country:US
Mailing Address - Phone:706-660-4908
Mailing Address - Fax:706-324-5425
Practice Address - Street 1:2000 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8927
Practice Address - Country:US
Practice Address - Phone:706-660-4908
Practice Address - Fax:706-324-5425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25332207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000278132GMedicaid
GAD45050Medicare UPIN