Davidson, Benton John
Davidson, Benton John is an sole proprietor health care provider with primary practice located at 1174 Cornucopia St Nw Suite 240, Salem OR 97304-3193. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Davidson, Benton John can be contacted via phone (503) 385-1664.Contact Information
Primary practice address
1174 Cornucopia St Nw Suite 240
Salem OR 97304-3193
Phone: (503) 385-1664
Fax: (503) 991-5768
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD21643 | Oregon |
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | MD21643 | Oregon |
Profile Details
| NPI number | 1013944016 |
|---|---|
| LBN Legal business name | Davidson, Benton John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Mar 28th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013944016 | NPPES |
| Oregon | MEDICAID | 288103 |
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