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Individual

MRS. STEPHANIE FAYE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1014 FORSYTH ST, MACON, GA 31201-2051
(478) 633-8100
Mailing address
5661 OCMULGEE EAST BLVD, MACON, GA 31217-5797
(478) 960-9592

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN251069
GA
2080P0006X
Developmental - Behavioral Pediatrics Physician
RN251069
GA

Other

Enumeration date
12/04/2023
Last updated
09/29/2025
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