Organization
THOMAS W. BENNINGER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS W BENNINGER MD (SOLO MEMBER OWNER)
(502) 897-2531
Entity
Organization
Contact information
Practice address
4121 DUTCHMANS LN, SUITE 101, LOUISVILLE, KY 40207-4707
(502) 897-9416
(502) 896-8660
Mailing address
4121 DUTCHMANS LN, SUITE 101, LOUISVILLE, KY 40207-4707
(502) 897-2531
(502) 896-5863
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
22073
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000247202
ANTHEM
KY
01
—
50000083
PASSPORT
KY
05
—
64220734
—
KY
Enumeration date
10/26/2006
Last updated
03/18/2010
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