MEDICARE: KATHLEEN MARIE BENSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	10162	NV
2	207R00000X	Internal Medicine Physician	10162	NV
3	207RC0000X	Cardiovascular Disease Physician	10162	NV
4	207RI0011X	Interventional Cardiology Physician	10162	NV

General Provider Information

NPI Number	:	1235207309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN MARIE BENSON MD

Provider Business Mailing Address
First Line	:	3016 W CHARLESTON BLVD
Second Line	:	STE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1973
Country	:	US
Telephone Number	:	702-218-0915
Fax Number	:

Provider Business Practice Location Address
First Line	:	4432 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119
Country	:	US
Telephone Number	:	702-733-2982
Fax Number	:	702-733-3824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	11/19/2020

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Directions to “ KATHLEEN MARIE BENSON MD” Practice Location

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