Provider Demographics
NPI:1922038348
Name:BENSON, PAUL ANDREW SCOTT (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ANDREW SCOTT
Last Name:BENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 E. 41ST STREET, ROOM 2A41
Mailing Address - Street 2:OU-TULSA SCHOOL OF COMMUNITY MEDICINE
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135
Mailing Address - Country:US
Mailing Address - Phone:918-660-3400
Mailing Address - Fax:918-660-3410
Practice Address - Street 1:4444 E. 41ST STREET, 2ND FLOOR
Practice Address - Street 2:OU PHYSICIANS -- PEDIATRICS
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135
Practice Address - Country:US
Practice Address - Phone:918-660-3400
Practice Address - Fax:918-660-3410
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350880352080A0000X
OK300992080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine