Individual
JEFFREY R BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1544 GREENVIEW DR SW, ROCHESTER, MN 55902-4322
(507) 287-2711
Mailing address
1544 GREENVIEW DR SW, ROCHESTER, MN 55902-4322
(507) 287-2711
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2298
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
671825600
—
MN
01
—
P00728901
RAILROAD MEDICARE
MN
Enumeration date
02/24/2006
Last updated
08/06/2024
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