Individual
AUSTIN CHARLES BENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-5889
(570) 837-6600
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA062295
PA
363A00000X
Physician Assistant
Primary
OA005540
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1038793050001
—
PA
01
—
1N4857
MEDICARE
PA
Enumeration date
12/16/2020
Last updated
04/22/2022
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