Individual
DR. JASON B. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
770 KENMOOR AVE SE STE 301, GRAND RAPIDS, MI 49546-8621
(616) 290-1876
(616) 290-1877
Mailing address
770 KENMOOR AVE SE STE 301, STE 301, GRAND RAPIDS, MI 49546-8621
(616) 290-1876
(616) 290-1876
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
4301076635
MI
Other
Enumeration date
07/24/2006
Last updated
06/05/2026
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