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Individual

DR. BENJAMIN STRANGE COOLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5348 LAMME RD, MORAINE, OH 45439-3215
(937) 534-4651
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01078397A
IN
2084P0800X
Psychiatry Physician
Primary
35.143409
OH
390200000X
Student in an Organized Health Care Education/Training Program
11018106A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11018106A
PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
05/21/2015
Last updated
11/20/2024
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