Individual provider · Type 1 NPI

Benjamin Waters Theisen, DO

Student in an Organized Health Care Education/Training Program · Little Rock, AR

NPI number 1235718529 Active

Practice location

1 Childrens Way # 512-19A
Little Rock, AR 72202-3500

Call (501) 364-1874 Map

Mailing address

1 Childrens Way # 512-3
Little Rock, AR 72202-3500

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1235718529

Benjamin Waters Theisen, DO's National Provider Identifier is 1235718529, issued on Apr 5, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Little Rock, AR. The record was last updated on Jun 27, 2024.