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NPI 1932213972

NPI 1932213972 : DAVID R BENSON MD : OLNEY, IL

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General NPI Number Information
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    NPI Number           |    1932213972
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID R BENSON MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/18/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1200 N EAST ST 
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    City                 |    OLNEY
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    State                |    IL
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    Zip                  |    62450-2499
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    Country              |    US
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    Telephone            |    618-395-5222
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    Fax                  |    618-395-8552
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Provider Business Mailing Address
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    Address Line         |    1200 N EAST ST WEBER MEDICAL CLINIC LTD
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    City                 |    OLNEY
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    State                |    IL
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    Zip                  |    62450-2499
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    Country              |    US
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    Telephone            |    618-395-5222
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    Fax                  |    618-395-8552
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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        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    
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    License Number State |    IL
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