Individual
BENJAMIN NYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(928) 533-3068
Mailing address
6675 HOLMES RD STE 450, KANSAS CITY, MO 64131-1173
(816) 276-7600
(816) 276-7992
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
6043
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2022
Last updated
06/03/2025
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