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Individual
DR. BENNY FAIR JR.
Active
Individual
DR. BENNY FAIR JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000728
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000331259
BLUE CROSS
—
05
—
100082090A
—
IN
01
—
P00128864
RR MEDICARE
—
Enumeration date
09/06/2006
Last updated
01/02/2025
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