Individual
BRIAN BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1108 PORT ARTHUR TER, LEESVILLE, LA 71446-4600
(337) 239-1061
Mailing address
PO BOX 730, DERIDDER, LA 70634-0730
(337) 239-1061
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
326824
LA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
326864
LA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD001453
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003232377A
—
GA
Enumeration date
04/19/2017
Last updated
07/28/2021
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