Provider Demographics
NPI:1770371080
Name:DOLOWICH, BENJAMIN AARON (MS)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:AARON
Last Name:DOLOWICH
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 OLD CANTON RD FL 3
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5982
Mailing Address - Country:US
Mailing Address - Phone:601-984-5236
Mailing Address - Fax:
Practice Address - Street 1:4400 OLD CANTON RD FL 3
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5982
Practice Address - Country:US
Practice Address - Phone:523-660-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program