Benton, Todd A.

Benton, Todd A. is an individual health care provider with primary practice located at 101 Medical Park , Hattiesburg MS 39401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Benton, Todd A. can be contacted via phone (601) 579-3000.

Contact Information

Primary practice address
101 Medical Park Hattiesburg MS 39401
Phone: (601) 579-3000
Fax: (601) 579-5240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 18965 Mississippi

Profile Details

NPI number 1780666313
LBN Legal business name Benton, Todd A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Jul 21st, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780666313 NPPES
Alabama MEDICAID 009932113
Alabama MEDICAID 06279075
Alabama Other 6116387
Alabama Other 730-15546

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