Individual
DR. JONATHAN CHRISTOPHER BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
424 S 56TH ST STE 110, PHOENIX, AZ 85034-2177
(602) 685-5166
Mailing address
PO BOX 42210, PHOENIX, AZ 85080-2210
(623) 266-7770
(623) 322-4639
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0600003440
VT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301504318
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
67958
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
99058473A
IN
Other
Enumeration date
05/01/2007
Last updated
11/15/2022
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