Basic Information
| Provider Information | |||||||||
| NPI: | 1033571732 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRENNING | ||||||||
| FirstName: | BENJAMIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1003 WILLOW CREEK RD | ||||||||
| Address2: | |||||||||
| City: | PRESCOTT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863011641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9284452700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8000 E MAPLEWOOD AVE BLDG 5 STE 200 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037854700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2016 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 64166 | AZ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.