Provider Demographics
NPI:1063732352
Name:JOHN R BENSON, M.D. (P.A.)
Entity type:Organization
Organization Name:JOHN R BENSON, M.D. (P.A.)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-525-2274
Mailing Address - Street 1:1062 E LANCASTER AVE
Mailing Address - Street 2:ROSEMONT PLAZA APTS STE 7
Mailing Address - City:ROSEMONT
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1568
Mailing Address - Country:US
Mailing Address - Phone:610-525-2274
Mailing Address - Fax:610-526-0726
Practice Address - Street 1:1062 E LANCASTER AVE
Practice Address - Street 2:ROSEMONT PLAZA APTS STE 7
Practice Address - City:ROSEMONT
Practice Address - State:PA
Practice Address - Zip Code:19010-1568
Practice Address - Country:US
Practice Address - Phone:610-525-2274
Practice Address - Fax:610-526-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAP.A.MD#024939L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty