Provider Demographics
NPI:1700229317
Name:CARRLE, BENJAMIN AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:AARON
Last Name:CARRLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12029 SHERATON LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-1611
Mailing Address - Country:US
Mailing Address - Phone:513-874-8111
Mailing Address - Fax:513-860-6992
Practice Address - Street 1:12029 SHERATON LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-1611
Practice Address - Country:US
Practice Address - Phone:513-874-8111
Practice Address - Fax:513-860-6992
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1270412085R0204X, 2085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program