Individual
BENJAMIN ALAN JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1801 GADSDEN HWY, BIRMINGHAM, AL 35235-3134
(205) 838-3900
(205) 838-3906
Mailing address
1801 GADSDEN HWY, BIRMINGHAM, AL 35235-3134
(205) 838-3900
(205) 838-3906
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-160
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51520839
BLUE CROSS BLUE SHIELD
AL
Enumeration date
02/08/2006
Last updated
05/13/2016
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