DR. BENJAMIN MATTHEW MAUCK (NPI# 1982828364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982828364 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN MATTHEW MAUCK |
| Credential | M.D. |
| Practice Address |
1458 W Poplar Ave Ste 100 Collierville TN 38017-0630 |
| Mailing Address |
1400 S Germantown Rd Germantown TN 38138-2205 |
| Practice Telephone | 9017593100 |
| Practice Fax Number | 9017595571 |
| Mailing Telephone | 9017593100 |
| Mailing Fax Number | 9017593196 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2018-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
22342 | MS | Allopathic & Osteopathic Physicians |
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
45172 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 194518001 | 05 | |
| TN | 1529559 | 05 | |
| MS | 01984078 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1211 Union Ave Ste 500, Memphis, TN 381046656 | 9017593100 | |
| 1400 S Germantown Rd, Germantown, TN 381382205 | 9017593100 | |
| 7545 Airways Blvd, Southaven, MS 386715806 | 9017593100 | |
| 8000 Centerview Pkwy Ste 500, Cordova, TN 380184254 | 9017593100 |
| Street Address |
1458 W POPLAR AVE STE 100 |
| City | COLLIERVILLE |
| State | TN |
| Zip Code | 38017-0630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053601591 | Tyler James Brolin | Orthopaedic Surgery | 1458 W Poplar Ave Ste 100, Collierville, TN 38017-0630 | 2011-04-18 |
| 1619152642 | Campbell Clinic PC | Durable Medical Equipment & Medical Supplies | 1458 W Poplar Ave Ste 100, Collierville, TN 38017-0630 | 2008-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827338 | George Nathan Freeman IIi | Chiropractor | 2028 W. Poplar, Suite 105, Collierville, TN 38017 | 2020-10-01 |
| 1104440171 | Cecelia Hunt | Social Worker | 2555 Halle Parkwsy, Collierville, TN 38017 | 2020-06-04 |
| 1053803403 | Sarah Harris | Physical Therapist | 605 Heather Lake Cv, Collierville, TN 38017 | 2018-06-01 |
| 1023507811 | Sandra P Morris | Pharmacist | 560 West Poplar, Collierville, TN 38017 | 2018-05-07 |
| 1043751159 | Rahim Panjwani | Physical Therapist | 2028 W. Poplar Ave, Collierville, TN 38017 | 2017-03-09 |
| 1104273234 | The Branch House | Counselor | 562 Center St, Collierville, TN 38017 | 2016-05-18 |
| 1760840052 | Amodeo Chiropractic Center Inc | Chiropractor | 161 Hwy 72 East, Collierville, TN 38017 | 2016-02-02 |
| 1235520628 | Bonnie Morales | Nurse Practitioner | 472 W. Poplar Ave, Collierville, TN 38017 | 2015-02-06 |
| 1841616513 | First Choice Transportation | Non-emergency Medical Transport (VAN) | 336 E. Valleywood Drive, Collierville, TN 38017 | 2014-03-05 |
| 1821424276 | Shana Cole Cannon | Licensed Practical Nurse | 777 W. Poplar Ave., Suite 104, Collierville, TN 38017 | 2013-09-17 |
| Find all providers in zip 38017 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174508808 | Edward Brantley Burns Jr. | Orthopaedic Surgery | 1819 W Clinch Ave Ste 100, Knoxville, TN 37916 | 2005-12-15 |
| 1124029699 | Paul A Abbey | Orthopaedic Surgery | 5653 Frist Blvd Ste 731, Hermitage, TN 37076-2066 | 2005-08-09 |
| 1942206859 | Paul William Gorman | Orthopaedic Surgery | 2335 Knob Creek Rd Ste 100, Johnson City, TN 37604-2002 | 2005-06-24 |
| 1023357639 | The Plastic Surgery Group,pc | Orthopaedic Surgery | 7380 Volkswagen Dr, Suite 130, Chattanooga, TN 37416-1755 | 2013-02-04 |
| 1245527506 | Todd A Rubin | Orthopaedic Surgery | 2400 Patterson St Ste 300, Nashville, TN 37203-1558 | 2011-07-06 |
| 1538468038 | Brinkley Kwyn Sandvall | Orthopaedic Surgery | 3601 The Vanderbilt Clinic, Nashville, TN 37232-1032 | 2011-03-23 |
| 1326276676 | Brian Drolet | Orthopaedic Surgery | 3601 The Vanderbilt Clinic, Nashville, TN 37232-5100 | 2009-06-25 |
| 1952536641 | Norfleet Buckner Thompson | Orthopaedic Surgery | 1400 S Germantown Rd, Germantown, TN 38138-2205 | 2009-05-25 |
| 1962644658 | Mihir Desai | Orthopaedic Surgery | 1215 21st Ave S, Mce. S.tower Ste 3200, Nashville, TN 37232-8828 | 2009-03-27 |
| 1023281896 | West Tennessee Hand Center, Pllc | Orthopaedic Surgery | 19 Security Dr, Jackson, TN 38305-3626 | 2008-04-11 |
| Find all providers with the same taxonomy | ||||
| City | COLLIERVILLE |
| Zip Code | 38017 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.