Individual
DANA RANSOM BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 S CRESCENT DR, PUEBLO WEST, CO 81007-5433
(719) 595-7575
(719) 547-8368
Mailing address
PO BOX 560825, DENVER, CO 80256-0825
(719) 595-7580
(719) 545-0176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21659
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01216597
—
CO
Enumeration date
04/27/2007
Last updated
02/16/2016
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