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General NPI Number Information
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NPI Number | 1316680457
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Entity Type | Individual
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Provider Name | BENTON LEE HURT DO
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Gender | Male
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Dates
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Enumeration Date | 04/17/2022
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 165 I STREET BUIDLING 402
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City | CAMP LEJEUNE
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State | NC
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Zip | 25847
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Country | US
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Telephone | 910-449-8846
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Fax |
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Provider Business Mailing Address
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Address Line | 165 I STREET HP402
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City | CAMP LEJEUNE
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State | NC
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Zip | 28547
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Country | US
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Telephone | 615-761-6200
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Fax |
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 0102208072
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License Number State | VA
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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 | 0102208072
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License Number State | VA
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