MR. BENJAMIN PUCKETT DIVE IDC
NPI 1881072726
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Q: What is Benjamin Puckett's NPI number?

The NPI number for Benjamin Puckett is 1881072726. It was assigned to this individual provider in the NPPES registry on May 12, 2015.

Q: What is Benjamin Puckett's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Puckett was last updated on May 12, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 12, 2015

2661 A ST, SAN DIEGO, CA 92102(808) 489-6160 Get Directions Write a Review

NPPES record last updated: May 12, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Benjamin Puckett Dive Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BENJAMIN PUCKETT DIVE IDC (NPI 1881072726) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since May 2015.

NPPES Registry Identity

NPI1881072726

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. BENJAMIN PUCKETTCredential: DIVE IDC

Location Address2661 A STSan Diego, CA 92102-1009

Mailing Address2661 A StSan Diego, CA 92102-1009 · (808) 489-6160

Phone(808) 489-6160

Sole ProprietorNo

Enumeration DateMay 12, 2015

✔ NPI 1881072726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

2661 A ST, San Diego, CA 92102

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Puckett's NPI number?

The NPI number for Benjamin Puckett is 1881072726. It was assigned to this individual provider in the NPPES registry on May 12, 2015.

Where is Benjamin Puckett located?

Benjamin Puckett practices at 2661 A St, San Diego, CA 92102. The listed phone number is (808) 489-6160.

What is Benjamin Puckett's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Benjamin Puckett was last updated on May 12, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.