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Individual

DR. HOLLY J. BENEDICT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1106 W JACKSON ST, OZARK, MO 65721-9164
(417) 581-3548
(417) 581-6164
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4N58
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202863817
MO
Enumeration date
10/12/2006
Last updated
05/02/2013
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