Individual
MICHAEL DOUGLAS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2626 ALEXANDRIA PIKE STE 100, HIGHLAND HEIGHTS, KY 41076-1530
(859) 301-2663
(859) 817-7848
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 817-7848
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.004487
OH
363A00000X
Physician Assistant
Primary
PA2067
KY
Other
Enumeration date
10/16/2015
Last updated
12/05/2023
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