Provider Demographics
NPI:1184159501
Name:LEVRON, BENJAMIN NELSON (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:NELSON
Last Name:LEVRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:NELSON
Other - Last Name:LEVRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8680 BLUEBONNET BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-7825
Mailing Address - Country:US
Mailing Address - Phone:225-333-3590
Mailing Address - Fax:225-333-3680
Practice Address - Street 1:8680 BLUEBONNET BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7825
Practice Address - Country:US
Practice Address - Phone:225-333-3590
Practice Address - Fax:225-333-3680
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-23
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA323682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine