Individual
DR. JASON B. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5060 CASCADE RD SE STE C-1, GRAND RAPIDS, MI 49546-3808
(616) 290-1876
(616) 290-1877
Mailing address
5060 CASCADE RD SE STE C-1, GRAND RAPIDS, MI 49546-3808
(616) 290-1876
(616) 290-1877
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
08/28/2022
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