Doctor Name: | DR. LESTER E BENN |
NPI Number: | 1235338898 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 031205 |
Business Practice Address: | 777 Cleveland Ave Sw Suite 701 Atlanta, GA - 303157129 |
Business Phone Number: | 4047671226 |
Business Fax Number: | 4047671223 |
Mailing Address: | 306 Ritchfield Dr, POWDER SPRINGS |
State: | GA |
Postal Code: | 301276550 |
Phone Number: | 7708966133 |
Fax Number: | |
NPI Enumeration Date: | 07/13/2007 |
NPI Last Update Date: | 07/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 031205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |