Individual
DR. BENJAMIN CLARK DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2000
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
15975
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00839845
—
MS
01
—
370000378
MEDICARE PIN 2007
MS
Enumeration date
06/26/2006
Last updated
06/14/2012
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