Individual
BENJAMIN LUKE CLUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 MCDOWELL ST, ASHEVILLE, NC 28801-4104
(828) 255-3749
(828) 254-9925
Mailing address
DEPT. 453 PO BOX 1000, MEMPHIS, TN 38148-0001
(828) 350-2163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12467
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982353454
—
NC
01
—
NNM517A
MEDICARE PTAN
NC
Enumeration date
03/22/2022
Last updated
10/30/2023
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