Provider Demographics
NPI:1114965704
Name:BENTON FRANKLIN ORTHOPEDIC ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:BENTON FRANKLIN ORTHOPEDIC ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEITZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-586-2828
Mailing Address - Street 1:8200 W GAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8113
Mailing Address - Country:US
Mailing Address - Phone:509-586-2828
Mailing Address - Fax:509-586-2525
Practice Address - Street 1:8200 W GAGE BLVD
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8113
Practice Address - Country:US
Practice Address - Phone:509-586-2828
Practice Address - Fax:509-586-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA147217OtherLABOR & INDUSTRIES
WA7106636Medicaid
WAAB19869Medicare PIN