Benton Family Medicine, LLC

NPI #1811129745 in Benton, Louisiana

Provider Information

NPI Number: 1811129745
Entity Type: Organization
Organization Name: Benton Family Medicine, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Aug 11, 2009
Last Updated: Aug 11, 2009

Practice Location

Address: 188 BURT BLVD
City: Benton
State: Louisiana
ZIP Code: 71006-4900
Phone: (318) 965-1000

Authorized Official

Name: MS. KELLEY NOVAK
Title: PHYSICIAN ASSISTANT
Phone: (318) 965-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Family — Family	363LF0000X
Internal Medicine	207R00000X	Primary

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