Individual
MR. BENJAMIN JACK SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
65 MESSIMER DR, NEWARK, OH 43055-1874
(740) 294-0649
Mailing address
65 MESSIMER DR, NEWARK, OH 43055-1874
(740) 294-0649
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OH
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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