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General NPI Number Information
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NPI Number | 1437133121
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Entity Type | Individual
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Provider Name | JERRY MICHAEL BENFIELD JR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 801 BARRET AVE STE 112
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City | LOUISVILLE
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State | KY
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Zip | 40204
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Country | US
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Telephone | 502-200-8259
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Fax | 502-584-8379
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Provider Business Mailing Address
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Address Line | 801 BARRET AVE STE 112
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City | LOUISVILLE
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State | KY
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Zip | 40204-1732
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Country | US
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Telephone | 502-327-9100
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Fax | 855-632-8329
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01056286A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME122430
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 38836
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License Number State | KY
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