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General NPI Number Information
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NPI Number | 1528395928
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Entity Type | Individual
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Provider Name | WILLIAM A BENZ PA
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Gender | Male
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Dates
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Enumeration Date | 11/06/2009
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | PO BOX 1276
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City | THOMASVILLE
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State | GA
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Zip | 31799-1276
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Country | US
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Telephone | 229-236-0831
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Fax |
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Provider Business Mailing Address
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Address Line | 5 EXECUTIVE CIR
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City | SAVANNAH
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State | GA
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Zip | 31406-3345
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Country | US
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Telephone | 912-355-2400
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Fax | 912-355-5324
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9112412
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 005709
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License Number State | GA
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