Provider Demographics
NPI:1609887967
Name:PEERY, BEN N (MD)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:N
Last Name:PEERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:614 NORTHBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-2190
Mailing Address - Country:US
Mailing Address - Phone:970-963-2732
Mailing Address - Fax:970-384-8173
Practice Address - Street 1:1906 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4227
Practice Address - Country:US
Practice Address - Phone:970-945-6535
Practice Address - Fax:970-384-8173
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2013-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO44507207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00699588OtherRR MEDICARE
CO83624066Medicaid
CO83624066Medicaid