Individual
DR. BENJAMIN JOEL COLLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 TERRA CROSSING BLVD STE 101, LOUISVILLE, KY 40245-5395
(502) 210-4600
(502) 210-4602
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56031
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300063886
—
IN
05
—
7100824890
—
KY
Enumeration date
06/18/2019
Last updated
07/10/2024
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