Individual
DR. SCOTT ANTHONY BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-0115
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-0115
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
20296
MS
2080C0008X
Child Abuse Pediatrics Physician
Primary
20296
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1989690
—
LA
Enumeration date
08/15/2005
Last updated
08/17/2012
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