Individual
KELLY M BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2724 NASHVILLE RD, BOWLING GREEN, KY 42101-4000
(270) 781-5111
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1708
(270) 781-5111
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35122871
OH
208000000X
Pediatrics Physician
Primary
58177
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114738
—
OH
Enumeration date
04/11/2011
Last updated
07/10/2023
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