Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 51371 | TN |
NPI | 1003044033 |
---|---|
Provider Name | Charles Daniel Benson |
First Address | Oak Ridge, TN 37830-6474 |
Second Address | Oak Ridge, TN 37830-6474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 14/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2249733 | CIGNA (01) | TN |
6024967 | BLUECROSS BLUESHIELD (01) | TN |
P01460328 | MEDICARE RAILROAD (01) | TN |
Q007795 | (05) | TN |