Individual
DR. DANIEL BRUCE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E MATTHEWS AVE, SUITE B, JONESBORO, AR 72401-4307
(870) 932-6883
(870) 972-0719
Mailing address
1000 E MATTHEWS AVE, SUITE B, JONESBORO, AR 72401-4307
(870) 932-6883
(870) 972-0719
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
E2282
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138617001
—
AR
Enumeration date
08/17/2006
Last updated
06/13/2016
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