Individual
DR. BENJAMIN SALAZAR YABUT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(316) 321-3300
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-44021
KS
207R00000X
Internal Medicine Physician
0444021
KS
208000000X
Pediatrics Physician
01041325A
IN
208000000X
Pediatrics Physician
Primary
0444021
KS
208D00000X
General Practice Physician
0444021
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001635078
BLUE CROSS BLUE SHIELD OF ILLINOIS
—
01
—
0007055591
AETNA
—
05
—
036-085422
—
IL
Enumeration date
01/03/2006
Last updated
09/09/2022
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