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General NPI Number Information
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NPI Number | 1487093738
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Entity Type | Individual
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Provider Name | JENNA M BENSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1200 HIGHMARKET ST STE 200
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City | GEORGETOWN
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State | SC
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Zip | 29440-3227
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Country | US
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Telephone | 843-546-8421
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Fax | 843-546-1173
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Provider Business Mailing Address
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Address Line | 90 CEDAR LIGHT LN
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City | LITTLE RIVER
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State | SC
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Zip | 29566-6978
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Country | US
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Telephone | 843-280-8779
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Fax | 843-280-6669
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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 | 191953
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 1487093738
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 51498
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License Number State | SC
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