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General NPI Number Information
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NPI Number | 1174723274
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Entity Type | Organization
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Legal Business Name | MESA FAMILY PHYSICIANS, PLC
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 1425 S GREENFIELD RD STE 101
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City | MESA
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State | AZ
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Zip | 85206-5505
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Country | US
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Telephone | 480-964-5800
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Fax | 480-644-1372
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Provider Business Mailing Address
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Address Line | 1425 S GREENFIELD RD STE 101
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City | MESA
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State | AZ
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Zip | 85206-5505
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Country | US
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Telephone | 480-964-5800
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Fax | 480-632-5923
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DAVID E. BENTON II
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Credential | M.D.
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Telephone | 480-964-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 14219
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13293
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10054
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License Number State | AZ
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