Individual
DR. ROBERT W BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 N 5TH ST, PONCHATOULA, LA 70454-2532
(985) 370-7768
Mailing address
180 N 5TH ST, PONCHATOULA, LA 70454-2532
(985) 370-7768
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
013754
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1175358
—
LA
Enumeration date
06/09/2005
Last updated
12/01/2007
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