Individual
BENJAMIN DAVID WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 VIRGINIA AVE, COLUMBIA, MO 65212-0001
(573) 882-2663
(573) 884-1284
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2016018234
MO
208100000X
Physical Medicine & Rehabilitation Physician
2021031129
MO
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
125075445
IL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2021031129
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2016
Last updated
12/07/2021
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