Individual
NICK C BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1150
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD17580
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044896
—
OR
Enumeration date
05/10/2006
Last updated
02/23/2011
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