Provider Demographics
NPI:1144457284
Name:KILMAN, BENTON ERNEST (MD)
Entity type:Individual
Prefix:DR
First Name:BENTON
Middle Name:ERNEST
Last Name:KILMAN
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 1:1 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843-9001
Mailing Address - Country:US
Mailing Address - Phone:662-862-5200
Mailing Address - Fax:662-862-5297
Practice Address - Street 1:1 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843-9001
Practice Address - Country:US
Practice Address - Phone:662-862-5200
Practice Address - Fax:662-862-5297
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine