Individual
ALBERT BENNETTE ST. JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21075 RABREN RD, ANDALUSIA, AL 36421-8115
(334) 222-9646
(334) 222-9646
Mailing address
21075 RABREN RD, ANDALUSIA, AL 36421-8115
(334) 222-9646
(334) 222-9646
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
11531
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000031289
—
AL
01
—
11531
STATE LICENSE/CONTROLLED
AL
01
—
510-31289ST
BLUE CROSS
AL
Enumeration date
01/23/2008
Last updated
03/07/2023
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