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Individual

DR. GREGORY DANIEL BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5585 THOMASTON RD STE A600, MACON, GA 31220-8200
(478) 219-9514
(478) 259-2836
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
080265
GA
207R00000X
Internal Medicine Physician
Primary
80265
GA

Other

Enumeration date
05/22/2007
Last updated
08/31/2021
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