Provider Demographics
NPI:1891739363
Name:BENJAMIN P RECHNER MD PC
Entity type:Organization
Organization Name:BENJAMIN P RECHNER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RECHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-942-9260
Mailing Address - Street 1:985 PARCHMENT DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3659
Mailing Address - Country:US
Mailing Address - Phone:616-942-9260
Mailing Address - Fax:616-942-1971
Practice Address - Street 1:985 PARCHMENT DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3659
Practice Address - Country:US
Practice Address - Phone:616-942-9260
Practice Address - Fax:616-942-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010702492086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4864752Medicaid
MIH91966Medicare UPIN