Provider Demographics
NPI:1003044033
Name:BENSON, CHARLES DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:DANIEL
Last Name:BENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 PARKSIDE DR STE 330
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1926
Mailing Address - Country:US
Mailing Address - Phone:865-218-7480
Mailing Address - Fax:865-218-7488
Practice Address - Street 1:10800 PARKSIDE DR STE 330
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1926
Practice Address - Country:US
Practice Address - Phone:865-218-7480
Practice Address - Fax:865-218-7488
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51371207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2249733OtherCIGNA
TN6024967OtherBLUECROSS BLUESHIELD
TNP01460328OtherMEDICARE RAILROAD
TNQ007795Medicaid
TN103I204234Medicare PIN
TN6024967OtherBLUECROSS BLUESHIELD