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1558367995

NPI Code Detail

MEDICARE: DR. JEAN S BENSON MD

MEDICARE: DR. JEAN S 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	207P00000X	Emergency Medicine Physician	15280	NH
2	207P00000X	Emergency Medicine Physician	MD14059	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	080116794	OTHER	ME	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	024823	OTHER	ME	ANTHEM STAR NUMBER
2	1042511	OTHER	ME	AETNA HMO
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	5976606	OTHER	ME	AETNA POS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558367995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEAN S BENSON MD

Provider Business Mailing Address
First Line	:	PO BOX 468
Second Line	:
City	:	SKOWHEGAN
State	:	ME
Zip	:	04976-0468
Country	:	US
Telephone Number	:	207-474-5121
Fax Number	:

Provider Business Practice Location Address
First Line	:	173 MIDDLE ST
Second Line	:
City	:	LANCASTER
State	:	NH
Zip	:	03584-3508
Country	:	US
Telephone Number	:	603-788-4911
Fax Number	:

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	04/06/2021

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Directions to “ DR. JEAN S BENSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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