Individual
BENJAMIN G VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4765 VILLAGE PLAZA LOOP, SUITE 100, EUGENE, OR 97401
(541) 485-7546
(541) 345-5254
Mailing address
PO BOX 5679, EUGENE, OR 97405
(541) 485-7546
(541) 345-5254
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
103786
MN
207N00000X
Dermatology Physician
Primary
MD179361
OR
207N00000X
Dermatology Physician
MD60286336
WA
207ND0900X
Dermatopathology Physician
48763
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500715739
—
OR
05
—
926718
—
AZ
Enumeration date
06/08/2007
Last updated
06/12/2023
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