Provider Demographics
NPI:1649852997
Name:HARSTINE, BENJAMIN CRAIG (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:CRAIG
Last Name:HARSTINE
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 1:120 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ONAGA
Mailing Address - State:KS
Mailing Address - Zip Code:66521-9574
Mailing Address - Country:US
Mailing Address - Phone:785-889-4274
Mailing Address - Fax:785-889-7163
Practice Address - Street 1:120 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ONAGA
Practice Address - State:KS
Practice Address - Zip Code:66521-9574
Practice Address - Country:US
Practice Address - Phone:785-889-4274
Practice Address - Fax:785-889-7163
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10074688207Q00000X
KS0449717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine