Dr. Benton John Davidson
Neurologist Clinical Neurophysiologist
1174 Cornucopia St Nw Suite 240
Salem
, Oregon 97304-3193
Dr. Benton John Davidson
Neurologist Clinical Neurophysiologist
1174 Cornucopia St Nw Suite 240
Salem
, Oregon 97304-3193
(503) 991-5768
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About
Features
Specialties
- Neurologist
- Clinical Neurophysiologist
Languages spoken
- English
Location
First Address
- Dr. Benton John Davidson
- 1174 Cornucopia St Nw Suite 240
- Salem, OR
- Zip : 97304-3193
- Fax : (503) 991-5768
- Phone : (503) 385-1664
Second Address
- Dr. Benton John Davidson
- 1174 Cornucopia St Nw Suite 240
- Salem, OR
- Zip : 97304-3193
- Fax : (503) 991-5768
- Phone : (503) 385-1664
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | MD21643 | OR |
| N | 2084N0600X | Clinical Neurophysiologist | MD21643 | OR |
National Provider Identifier
| NPI | 1013944016 |
|---|---|
| Provider Name | Dr. Benton John Davidson |
| First Address | Salem, OR 97304-3193 |
| Second Address | Salem, OR 97304-3193 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/06/2006 |
| Last Update Date | 28/03/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 288103 | (05) | OR |
| G03664 | (02) | OR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.