Individual
KIRK BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
835 W UNIVERSITY DR, MESA, AZ 85201-5555
(480) 664-6007
Mailing address
835 W UNIVERSITY DR, MESA, AZ 85201-5555
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601009199
MI
363A00000X
Physician Assistant
Primary
62204
CA
363A00000X
Physician Assistant
9503
AZ
Other
Enumeration date
05/25/2019
Last updated
07/07/2025
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