Individual
JOHN W BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1421 PREMIERE DR, MANKATO CLINIC AT WICKERSHAM, MANKATO, MN 56001-6076
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56001-5066
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40637
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102892
MEDICA
MN
05
—
0511147
—
IA
01
—
08028065
RR MEDICARE
—
01
—
101044
UCARE
MN
01
—
29B64BE
BCBS
MN
01
—
41084933956001C120
CHAMPUS
—
05
—
829525500
—
MN
01
—
895654
AMERICAS PPO
MN
01
—
HP26511
HEALTH PARTNERS
MN
01
—
NA2951023816
PREFERRED ONE
MN
Enumeration date
01/18/2006
Last updated
07/09/2020
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