Provider Demographics
NPI:1821032483
Name:BENEDICT, JOHN F (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:BENEDICT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2123 AUBURN AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-721-7373
Mailing Address - Fax:513-977-4253
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-721-7373
Practice Address - Fax:513-977-4253
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077615208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2197028Medicaid
OHBE4173012Medicare PIN
OHG28266Medicare UPIN