MEDICARE: DR. PAUL A. BENZING O.D.

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	152W00000X	Optometrist	OH3111	OH

General Provider Information

NPI Number	:	1780610881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL A. BENZING O.D.

Provider Business Mailing Address
First Line	:	4601 EASTGATE BLVD
Second Line	:	SUITE C-578
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1218
Country	:	US
Telephone Number	:	513-753-4981
Fax Number	:	513-753-0371

Provider Business Practice Location Address
First Line	:	4601 EASTGATE BLVD
Second Line	:	SUITE C-578
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1218
Country	:	US
Telephone Number	:	513-753-4981
Fax Number	:	513-753-0371

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/09/2007

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