Individual
JEFFREY BENNIE
Active
Individual
JEFFREY BENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
021631
TN
207L00000X
Anesthesiology Physician
Primary
21631
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009991815
—
AL
01
—
3029953
BCBS PROVIDER NUMBER
TN
05
—
3058871
—
TN
05
—
610596345A
—
GA
05
—
64911480
—
KY
Enumeration date
06/16/2005
Last updated
08/20/2008
Update your record
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