Individual
DR. TODD A. BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 MEDICAL PARK, HATTIESBURG, MS 39401
(601) 579-3000
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-3000
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18965
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932113
—
AL
05
—
06279075
—
MS
01
—
6116387
HEALTHSPRING
MS
01
—
730-15546
BLUE CROSS OF AL
—
Enumeration date
11/18/2005
Last updated
07/21/2020
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