| Benjamin Newsom Llc | |
|
13 Heyman Ln Alexandria LA 71303-3574 | |
| (337) 303-6546 | |
| (318) 448-6454 |
| Full Name | Benjamin Newsom Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13 Heyman Ln, Alexandria, Louisiana |
| Authorized Official Name and Position | Benjamin Newsom (MD/OWNER) |
| Authorized Official Contact | 3373036546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Newsom Llc Po Box 13440 Alexandria LA 71315-3440 Ph: (337) 303-6546 | Benjamin Newsom Llc 13 Heyman Ln Alexandria LA 71303-3574 Ph: (337) 303-6546 |
| NPI Number | 1942805296 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 12/03/2020 |
| Medicare PECOS PAC ID | 4183039811 |
|---|---|
| Medicare Enrollment ID | O20210210002463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942805296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Benjamin Kyle Newsom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619233236 PECOS PAC ID: 4082920814 Enrollment ID: I20150825003267 |
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