Provider Demographics
NPI:1801945936
Name:BENJAMIN, LOUIS CHRISTOPHER III (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:CHRISTOPHER
Last Name:BENJAMIN
Suffix:III
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 1:18961 SANTA MARIA DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-6765
Mailing Address - Country:US
Mailing Address - Phone:225-246-2110
Mailing Address - Fax:
Practice Address - Street 1:18961 SANTA MARIA DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-6765
Practice Address - Country:US
Practice Address - Phone:225-246-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.201636208G00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1022306Medicaid
LA4K8396833Medicare PIN