Provider Demographics
NPI:1982880209
Name:BENTON, GEORGE R IV (CRNA)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:R
Last Name:BENTON
Suffix:IV
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:191 BILTMORE AVENUE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4109
Mailing Address - Country:US
Mailing Address - Phone:828-350-3677
Mailing Address - Fax:615-327-7940
Practice Address - Street 1:1032 FLEMING ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3532
Practice Address - Country:US
Practice Address - Phone:828-696-3099
Practice Address - Fax:828-696-3868
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2020-03-13
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Provider Licenses
StateLicense IDTaxonomies
TN13023367500000X
TN78151367500000X
NC2092367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered