Provider Demographics
NPI:1669982898
Name:GARRISON, BENJAMIN C II (PA)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:C
Last Name:GARRISON
Suffix:II
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 OLDE GREENWICH DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4008
Mailing Address - Country:US
Mailing Address - Phone:540-374-5599
Mailing Address - Fax:540-735-8097
Practice Address - Street 1:4376 GERMANNA HWY
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:VA
Practice Address - Zip Code:22508-2008
Practice Address - Country:US
Practice Address - Phone:540-972-7798
Practice Address - Fax:540-972-3536
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110005951207R00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine