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Individual
JASON A. BENNETT
Active
Individual
JASON A. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
13423479-1205
UT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
21356
WV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD.205664
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD429260
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME154997
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000493642
ANTHEM
—
05
—
03223248
—
MS
05
—
1017445660001
—
PA
05
—
114105000
—
FL
01
—
1393196
AETNA HMOS
—
01
—
156840
GATEWAY
PA
01
—
1904630
HIGHMARK
PA
05
—
2304313
—
LA
05
—
2698906
—
OH
01
—
77644605
AETNA PPOS
—
01
—
7905789
CIGNA
—
Enumeration date
08/31/2006
Last updated
05/25/2023
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