Individual
DR. MICHAEL JOHN BENOIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1322 ELTON RD, SUITE D, JENNINGS, LA 70546-4138
(337) 824-1111
(337) 824-1122
Mailing address
1322 ELTON RD, SUITE D, JENNINGS, LA 70546-4138
(337) 824-1111
(337) 824-1122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
024980
LA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
024980
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445151
—
LA
01
—
45-0506014
TAX ID
—
Enumeration date
03/27/2006
Last updated
02/29/2016
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