Healthcare Provider Details

I. General information

NPI: 1922030956
Provider Name (Legal Business Name): JON CARTER BENSON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 HARDING MEMORIAL PKWY
MARION OH
43302-6365
US

IV. Provider business mailing address

1063 HARDING MEMORIAL PKWY
MARION OH
43302-6365
US

V. Phone/Fax

Practice location:
  • Phone: 740-244-8550
  • Fax: 740-751-4584
Mailing address:
  • Phone: 740-244-8550
  • Fax: 740-751-4584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50-00-0876
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: