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Individual

DR. JOHN B BENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3950 KRESGE WAY STE 308, LOUISVILLE, KY 40207-4637
(502) 895-8911
(502) 895-8977
Mailing address
PO BOX 9203, BELFAST, ME 04915-9203
(502) 895-9627
(502) 895-8977

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41725
KY
208M00000X
Hospitalist Physician
Primary
41725
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000300382
ANTHEM PROV#
IN
01
000000548736
ANTHEM
KY
01
000063095G
HUMANA
KY
05
200448900
IN
01
352154103
UNITED HEALTHCARE PROV
05
64117005
KY
01
P00049026
RAILROAD MEDICARE PROV#
IN
Enumeration date
08/22/2005
Last updated
07/21/2022
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