Provider Demographics
NPI:1780610881
Name:BENZING, PAUL A (OD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:BENZING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 EASTGATE BLVD
Mailing Address - Street 2:SUITE C-578
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1218
Mailing Address - Country:US
Mailing Address - Phone:513-753-4981
Mailing Address - Fax:513-753-0371
Practice Address - Street 1:4601 EASTGATE BLVD
Practice Address - Street 2:SUITE C-578
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1218
Practice Address - Country:US
Practice Address - Phone:513-753-4981
Practice Address - Fax:513-753-0371
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3111152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT47380Medicare UPIN