Provider Demographics
NPI:1831486661
Name:BENBOW, CATHERINE EDELE (DO)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:EDELE
Last Name:BENBOW
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:1423 N JEFFERSON AVE
Mailing Address - Street 2:STE B100
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-1917
Mailing Address - Country:US
Mailing Address - Phone:417-269-8817
Mailing Address - Fax:417-269-8744
Practice Address - Street 1:1423 N JEFFERSON AVE
Practice Address - Street 2:STE B100
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-1917
Practice Address - Country:US
Practice Address - Phone:417-269-8817
Practice Address - Fax:417-269-8744
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011018667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine