Benitone, Jerry D

Benitone, Jerry D is an individual health care provider with primary practice located at 2144 Monroe Ave , Memphis TN 38104-4229. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Benitone, Jerry D can be contacted via phone (901) 274-9046.

Contact Information

Primary practice address
2144 Monroe Ave Memphis TN 38104-4229
Phone: (901) 274-9046
Fax: (901) 272-7360
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD0000006809 Tennessee

Profile Details

NPI number 1629073119
LBN Legal business name Benitone, Jerry D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629073119 NPPES
Mississippi MEDICAID 00010364
Mississippi MEDICAID 3191624

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