Individual
DR. BEN B MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
926 N JACKSON ST, TULLAHOMA, TN 37388-2300
(931) 393-6004
(931) 393-4795
Mailing address
926 N JACKSON ST, TULLAHOMA, TN 37388-2300
(931) 393-6004
(931) 393-4795
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
TN18870
TN
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
TN18870
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3039979
—
TN
01
—
3074482
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/21/2005
Last updated
03/10/2021
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