# DR. TIMOTHY L. BENNETT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1710096755
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 04-20677 | KS | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | 04-20677 | KS | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | 2008011473 | MO | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 11/19/2020