Individual
JENNA M BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 HIGHMARKET ST STE 200, GEORGETOWN, SC 29440-3227
(843) 546-8421
(843) 546-1173
Mailing address
90 CEDAR LIGHT LN, LITTLE RIVER, SC 29566-6978
(843) 280-8779
(843) 280-6669
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
191953
NC
207W00000X
Ophthalmology Physician
1487093738
NC
207W00000X
Ophthalmology Physician
Primary
51498
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
514982
—
SC
Enumeration date
06/20/2013
Last updated
07/21/2022
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