Individual
BENTON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
LL36899
SC
2085R0202X
Diagnostic Radiology Physician
Primary
62158
CO
Other
Enumeration date
07/07/2014
Last updated
07/12/2019
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