Provider Demographics
NPI:1639769375
Name:BENSON, ADAM RYAN (DVM)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:RYAN
Last Name:BENSON
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 HIGHWAY 14 BYP
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-4240
Mailing Address - Country:US
Mailing Address - Phone:605-697-5200
Mailing Address - Fax:605-692-4609
Practice Address - Street 1:1907 HIGHWAY 14 BYP
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-4240
Practice Address - Country:US
Practice Address - Phone:605-697-5200
Practice Address - Fax:605-692-4609
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service