Most Relevant Information
Provider Data
| NPI Number: | 1003006115 |
| Provider Name: | BENJAMIN DURHAM PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 005084 |
Most Important Dates
| Enumeration Date: | 07/26/2007 |
| Last Updated: | 11/20/2020 |
Provider Practice Location
522 N CENTER ST
THOMASTON
GA
302863695
Practice Location Phone/Fax
| Phone: | 7066464371 |
| Fax: | 7066464372 |
Provider Mailing Location
PO BOX 370
FORTSON
GA
318080370
Provider Mailing Phone/Fax
| Phone: | |
| Fax: | 7064943008 |