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Individual

DONALD WALTER BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD MD

Contact information

Practice address
1935 BLUEGRASS AVE, SUITE 200, LOUISVILLE, KY 40215-1179
(502) 895-0040
(502) 361-4488
Mailing address
1935 BLUEGRASS AVE, SUITE 200, LOUISVILLE, KY 40215-1179
(502) 895-0040
(502) 361-4488

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23368
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200101170
IN
05
64233687
KY
Enumeration date
12/02/2005
Last updated
09/23/2013
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