# CAMILLA C. BENNETT MD PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1770622003
- **Authorized official:** DR. CAMILLA C. BENNETT MD (OWNER)
- **Authorized official phone:** (865) 670-1003

## Contact information

- **Practice address:** 200 FORT SANDERS WEST BLVD, SUITE 107, KNOXVILLE, TN 37922-3357
- **Practice address phone:** (865) 670-1003
- **Practice address fax:** (865) 670-1004
- **Mailing address:** 200 FORT SANDERS WEST BLVD, SUITE 107, KNOXVILLE, TN 37922-3357
- **Mailing address phone:** (865) 670-1003
- **Mailing address fax:** (865) 670-1004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/05/2007
- **Last updated:** 06/15/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3372803 | — | TN |