| Benjamin C Smith, MD | |
|
1027 Washington Ave, Detroit Lakes, MN 56501-3409 | |
| (218) 847-5611 | |
| (218) 847-0881 |
| Full Name | Benjamin C Smith |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 17 Years |
| Location | 1027 Washington Ave, Detroit Lakes, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831352947 | NPI | - | NPPES |
| 1831352947 | Medicaid | MN | |
| P01206393 | Other | MN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 104475 (Minnesota) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 52376 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Essentia Health St Marys - Detroit Lakes | Detroit lakes, MN | Hospital |
| Essentia Health | Fargo, ND | Hospital |
| Essentia Health St Joseph's Medical Center | Brainerd, MN | Hospital |
| St Josephs Area Health Services | Park rapids, MN | Hospital |
| Essentia Health Duluth | Duluth, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Marys Regional Health Center | 2062326820 | 158 |
| Entity Name | St Marys Regional Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679561088 PECOS PAC ID: 2062326820 Enrollment ID: O20031117000090 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin C Smith, MD 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611 | Benjamin C Smith, MD 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611 |
A. Douglas Landers, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 |