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General NPI Number Information
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NPI Number | 1194920025
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Entity Type | Individual
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Provider Name | JOSHUA M BENGE M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 2300 CHAMBER CENTER DR
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City | LAKESIDE PARK
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State | KY
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Zip | 41017-1686
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Country | US
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Telephone | 859-655-7040
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Fax | 859-331-2021
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Provider Business Mailing Address
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Address Line | PO BOX 635283
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City | CINCINNATI
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State | OH
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Zip | 45263-5283
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Country | US
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Telephone | 859-635-9440
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Fax | 859-448-2622
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 41949
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License Number State | KY
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