# SARITA L BENNETT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518168053
- **Authorized official:** DR. SARITA L BENNETT DO (OWNER)
- **Authorized official phone:** (304) 799-0011

## Contact information

- **Practice address:** RT 2 BOX 386, MARLINTON, WV 24954-9743
- **Practice address phone:** (304) 799-0011
- **Practice address fax:** (304) 799-0035
- **Mailing address:** RT 2 BOX 386, MARLINTON, WV 24954-9743
- **Mailing address phone:** (304) 799-0011
- **Mailing address fax:** (304) 799-0035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1755 | WV | — |
| 208D00000X | General Practice Physician | 1755 | WV | Yes |
| 251B00000X | Case Management Agency | 1755 | WV | — |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 03/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4902001000 | — | WV |
| 05 | — | 5600573000 | — | WV |