Provider Demographics
NPI:1356547749
Name:STONG, BENJAMIN COLLIN (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:COLLIN
Last Name:STONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:134 ANSLEY DR
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-1639
Mailing Address - Country:US
Mailing Address - Phone:706-864-5934
Mailing Address - Fax:
Practice Address - Street 1:134 ANSLEY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1639
Practice Address - Country:US
Practice Address - Phone:706-864-5934
Practice Address - Fax:706-864-4912
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054676207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology