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General NPI Number Information
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NPI Number | 1154821080
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Entity Type | Individual
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Provider Name | JORGE D BENITO DO
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Gender | Male
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1138 LEXINGTON RD STE 110
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City | GEORGETOWN
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State | KY
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Zip | 40324-9673
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Country | US
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Telephone | 502-570-3754
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Fax | 502-570-3456
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Provider Business Mailing Address
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Address Line | 404 SHOPPERS DR
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City | WINCHESTER
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State | KY
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Zip | 40391-1301
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Country | US
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Telephone | 859-737-5333
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Fax | 859-737-0070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 34.016480
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | TP119
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 05846
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License Number State | KY
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