Individual
MR. BENJAMIN LYAL JOSEPH SCRIVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
132 KAYLA DR, SOUTHAVEN, MS 38671-1806
(662) 897-9494
Mailing address
132 KAYLA DR, SOUTHAVEN, MS 38671-1806
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
—
MS
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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