Individual
DR. THOMAS HENRY BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 E STATE ROUTE K, WEST PLAINS, MO 65775-6616
(417) 257-2454
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(417) 257-2454
(417) 256-1119
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
C5130
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102262001
—
AR
Enumeration date
09/17/2006
Last updated
08/26/2016
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