Individual
DR. JON MICHAEL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7900 N KINGS HWY, MYRTLE BEACH, SC 29572-3055
(843) 449-3381
(843) 449-9721
Mailing address
7900 N KINGS HWY, MYRTLE BEACH, SC 29572-3055
(843) 449-3381
(843) 449-9721
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
37755
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX74530
—
CA
Enumeration date
12/07/2005
Last updated
10/10/2023
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