Individual
WILLIAM H. BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
417 W MARKET ST, ORRVILLE, OH 44667-1822
(330) 683-3963
(330) 683-3453
Mailing address
417 W MARKET ST, ORRVILLE, OH 44667-1822
(330) 683-3963
(330) 683-3453
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3278
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128787
ANTHEM PROVIDER NUMBER
OH
05
—
0339842
—
OH
01
—
0465661
PTAN/MEDICARE PROVIDER NUMBER
OH
01
—
341225963
MMO PROVIDER NUMBER
OH
Enumeration date
08/08/2006
Last updated
02/24/2015
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