Provider Demographics
NPI:1033071048
Name:VO, BENJAMIN VIET
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:VIET
Last Name:VO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 SAWYER MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-4361
Mailing Address - Country:US
Mailing Address - Phone:404-644-4839
Mailing Address - Fax:
Practice Address - Street 1:457 SAWYER MEADOW WAY
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-4361
Practice Address - Country:US
Practice Address - Phone:404-644-4839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-27
Last Update Date:2025-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant