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NPI Code Detail

MEDICARE: BENTON MCGILL PA-C

MEDICARE: BENTON MCGILL PA-C
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
1363A00000XPhysician Assistant6315SC

General Provider Information

NPI Number : 1750230678
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENTON MCGILL PA-C
Provider Business Mailing Address
First Line : 1601 CUMMINS DR STE D
Second Line :
City : MODESTO
State : CA
Zip : 95358-6411
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 125 COMMONWEALTH DR
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-4812
Country : US
Telephone Number : 864-675-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2026
Last Update Date : 04/13/2026

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Directions to “ BENTON MCGILL PA-C” Practice Location

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