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NPI Code Detail

MEDICARE: MRS. IVA JOYCE KATON-BENITEZ PA

MEDICARE: MRS. IVA JOYCE KATON-BENITEZ PA
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
1363AS0400XSurgical Physician Assistant002038GA

General Provider Information

NPI Number : 1184803157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. IVA JOYCE KATON-BENITEZ PA
Provider Business Mailing Address
First Line : SOUTH ATLANTA MEDICAL ASSOCIATES, PC
Second Line : 1029 CLEVELAND AVENUE
City : EAST POINT
State : GA
Zip : 30344-6719
Country : US
Telephone Number : 404-768-4626
Fax Number : 404-768-4631
Provider Business Practice Location Address
First Line : SOUTH ATLANTA MEDICAL ASSOCIATES, PC
Second Line : 1029 CLEVELAND AVENUE
City : EAST POINT
State : GA
Zip : 30344-6719
Country : US
Telephone Number : 404-768-4626
Fax Number : 404-768-4631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2007
Last Update Date : 01/04/2019

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Directions to “ MRS. IVA JOYCE KATON-BENITEZ PA” Practice Location

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