Individual
JEFFREY BENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
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
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