Individual
DR. JOHN MARK BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
281 E MAIN ST, FOREST CITY, NC 28043-3126
(828) 245-6400
(828) 245-3838
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32922
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080115284
MEDICARE RR
NC
01
—
2150033E
MEDICARE PIN
NC
01
—
44365
MEDCOST
SC
05
—
8914885
—
NC
01
—
P01445426
RAILROAD MEDICARE
SC
Enumeration date
01/25/2006
Last updated
11/24/2020
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