Provider Demographics
NPI:1831472463
Name:ARTHUR, BENJAMIN THEODORE (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:THEODORE
Last Name:ARTHUR
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 1:646 CORNERSTONE PL
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6706
Mailing Address - Country:US
Mailing Address - Phone:706-787-1506
Mailing Address - Fax:106-787-7201
Practice Address - Street 1:300 W HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-787-1506
Practice Address - Fax:706-787-7201
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250217207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine