Individual
DR. JERRY D BENITONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2144 MONROE AVE, MEMPHIS, TN 38104-4229
(901) 274-9046
(901) 272-7360
Mailing address
2144 MONROE AVE, MEMPHIS, TN 38104-4229
(901) 274-9046
(901) 272-7360
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000006809
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010364
—
MS
05
—
3191624
—
TN
Enumeration date
06/20/2005
Last updated
07/09/2007
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