Individual
DR. JODY B. BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
96 15TH ST NW, SUITE 111, NORTON, VA 24273-1625
(276) 439-1860
(276) 439-1865
Mailing address
96 15TH ST NW, SUITE 111, NORTON, VA 24273-1625
(276) 439-1860
(276) 439-1865
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102201550
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083682983
—
VA
05
—
7100063400
—
KY
01
—
P00689801
RR MEDICARE
—
Enumeration date
03/08/2006
Last updated
01/27/2017
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