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Individual

TINA MARIE BENOIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
LSU MEDICINE CLINIC, 2390 W CONGRESS STREET, LAFAYETTE, LA 70506
(337) 261-6100
Mailing address
1340 POYDRAS ST, NEW ORLEANS, LA 70112-1221
(504) 412-1860

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
019505
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1933899
LA
Enumeration date
07/24/2006
Last updated
05/24/2017
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