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Individual

DR. BENNIE R UPCHURCH III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
99 N BRICE RD # N, COLUMBUS, OH 43213-6510
(614) 575-2600
Mailing address
99 N BRICE RD # N, COLUMBUS, OH 43213-6510
(614) 575-2600

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35067988
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0460353
OH
05
2879265
OH
Enumeration date
05/15/2006
Last updated
12/02/2023
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