Individual
DR. BENJAMIN C KAUTZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1233 E 2ND ST, CASPER, WY 82601-2926
(414) 719-2959
Mailing address
1233 E 2ND ST, SSB FL 3, CASPER, WY 82601-4756
(414) 719-2959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD452256
PA
2086S0102X
Surgical Critical Care Physician
Primary
MD452256
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14092612
CAQH
—
Enumeration date
06/21/2009
Last updated
11/20/2023
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