Organization
BENJAMIN J. CUNNINGHAM, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN CUNNINGHAM (PRESIDENT)
(432) 331-1234
Entity
Organization
Contact information
Practice address
600 N GRANT AVE, SUITE 200, ODESSA, TX 79761-4503
(432) 331-1234
Mailing address
PO BOX 1808, ODESSA, TX 79760-1808
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
L3618
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178954701
—
TX
Enumeration date
10/18/2007
Last updated
05/16/2011
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