Individual
JUDITH CECILE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 FORT BENNING RD, COLUMBUS, GA 31903-2834
(706) 322-9599
(706) 689-4340
Mailing address
1600 FORT BENNING RD, COLUMBUS, GA 31903-2834
(706) 322-9599
(706) 689-4340
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
033026
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000435674E
—
GA
05
—
123197
—
AL
Enumeration date
12/29/2006
Last updated
05/05/2015
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