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Individual
PHILLIP M. BENNETT
Active
Individual
PHILLIP M. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12404256-1204
UT
Other
Enumeration date
03/25/2020
Last updated
09/10/2021
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