Provider Demographics
NPI:1669727210
Name:PULLEY, BENJAMIN RICHARD (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:RICHARD
Last Name:PULLEY
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 1:6480 HARRISON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-818-0043
Mailing Address - Fax:513-964-9575
Practice Address - Street 1:2854 BELL ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1721
Practice Address - Country:US
Practice Address - Phone:740-588-6265
Practice Address - Fax:740-588-1081
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA148168207X00000X
OH122834207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery