Provider Demographics
NPI:1427011998
Name:BENSON, RUSSELL LEE (MD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:LEE
Last Name:BENSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26827
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-6827
Mailing Address - Country:US
Mailing Address - Phone:913-341-6297
Mailing Address - Fax:913-663-0191
Practice Address - Street 1:8005 W 110TH ST STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2619
Practice Address - Country:US
Practice Address - Phone:913-341-6297
Practice Address - Fax:913-663-0191
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-21976207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100121990BMedicaid
13338048OtherKS CITY BCBS
MO202593414Medicaid
MO202593414Medicaid
MOJ71A00006Medicare PIN
C51928Medicare UPIN
KS100121990BMedicaid
KSG977048Medicare PIN
KS220018852Medicare PIN