1093703035 NPI number — DR. DAVID C BENSON MD

Table of content: DR. DAVID C BENSON MD (NPI 1093703035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093703035 NPI number — DR. DAVID C BENSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BENSON
Provider First Name:
DAVID
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BENSON
Provider Other First Name:
DAVID
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1093703035
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 CANAL ST FL 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70112-3018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-702-4333
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 CANAL ST FL 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70112-3018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-702-4333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  016565 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208800000X , with the licence number: 25096 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: 01035659A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 340003585 . This is a "RR MCR" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: P00242544 . This is a "RR MCR" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64758030 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100362160 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1884073 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".