Individual
DR. WILLIAM JOSEPH BENEVENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 TANGLEFOOT LANE, EYE SURGEONS ASSOCIATES PC, BETTENDORF, IA 52722-1650
(563) 323-2020
(563) 328-5694
Mailing address
777 TANGLEFOOT LANE, EYE SURGEONS ASSOCIATES PC, BETTENDORF, IA 52722-1650
(563) 323-2020
(563) 328-5694
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036-088865
IL
207W00000X
Ophthalmology Physician
Primary
30004
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060350
IA GROUP MEDICAID #
IA
05
—
0114074
—
IA
05
—
036088865
—
IL
01
—
26568
IA GROUP MEDICARE #
IA
01
—
790730
IL GROUP MEDICARE #
IL
Enumeration date
12/28/2005
Last updated
03/31/2021
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