Basic Information
| Provider Information | |||||||||
| NPI: | 1922038348 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENSON | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | ANDREW SCOTT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4502 E. 41ST STREET, ROOM 2A41 | ||||||||
| Address2: | OU-TULSA SCHOOL OF COMMUNITY MEDICINE | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186603400 | ||||||||
| FaxNumber: | 9186603410 | ||||||||
| Practice Location | |||||||||
| Address1: | 4444 E. 41ST STREET, 2ND FLOOR | ||||||||
| Address2: | OU PHYSICIANS -- PEDIATRICS | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186603400 | ||||||||
| FaxNumber: | 9186603410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 10/24/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | 35088035 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | 2080A0000X | 30099 | OK | Y | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
No ID Information.