Provider Demographics
NPI:1265487011
Name:BENJAMIN F. TOWE, M.D., PC
Entity Type:Organization
Organization Name:BENJAMIN F. TOWE, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:TOWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-228-1677
Mailing Address - Street 1:210 OAK ST N
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5139
Mailing Address - Country:US
Mailing Address - Phone:706-228-1677
Mailing Address - Fax:706-228-5319
Practice Address - Street 1:210 OAK ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5139
Practice Address - Country:US
Practice Address - Phone:706-228-1677
Practice Address - Fax:706-228-5319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000232064RMedicaid
GAD41252Medicare UPIN