MEDICARE: LYNN KEVIN BENSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	66879	AZ
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1114580214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN KEVIN BENSON MD

Provider Business Mailing Address
First Line	:	839 W CONGRESS ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2819
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:	520-309-2560

Provider Business Practice Location Address
First Line	:	7490 S CAMINO DE OESTE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85746-9308
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:	520-309-2560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2019
Last Update Date	:	12/11/2025

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