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Individual

JOHN CHARLES BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
425 W 3RD AVE, SUITE 410, ALBANY, GA 31701-1941
(229) 312-0707
(229) 312-0705
Mailing address
500 W 3RD AVE, SUITE 101, ALBANY, GA 31701-1985
(229) 312-5839
(229) 312-5853

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
057581
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
057581
STATE MEDICAL LICENSE
GA
05
182727627D
GA
Enumeration date
05/05/2006
Last updated
02/08/2017
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