Organization
BENTON MEDICAL AND SURGICAL ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BEALE M.D. (PRESIDENT)
(270) 527-7400
Entity
Organization
Contact information
Practice address
619 OLD SYMSONIA ROAD, SUITE A, BENTON, KY 42025-5042
(270) 527-7400
(270) 527-2211
Mailing address
619 OLD SYMSONIA ROAD, SUITE A, BENTON, KY 42025-5042
(270) 527-7400
(270) 527-2211
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32012
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
659453130
—
KY
01
—
DF7028
RR MEDICARE
KY
Enumeration date
08/03/2006
Last updated
09/30/2009
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