Healthcare Provider Details

I. General information

NPI: 1417994989
Provider Name (Legal Business Name): MICHAEL BENOIT, APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 ELTON RD SUITE D
JENNINGS LA
70546-4138
US

IV. Provider business mailing address

1322 ELTON RD SUITE D
JENNINGS LA
70546-4138
US

V. Phone/Fax

Practice location:
  • Phone: 337-824-1111
  • Fax: 337-824-1122
Mailing address:
  • Phone: 337-824-1111
  • Fax: 337-824-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL JOHN BENOIT
Title or Position: DIRECTOR
Credential: M.D.
Phone: 337-824-1111