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Individual

MR. NATHAN KYLE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
349 BOGLE ST, SUITE B, SOMERSET, KY 42503-2895
(606) 451-9448
(606) 451-9540
Mailing address
80 BROWN HILL SCHOOL RD, FRAKES, KY 40940-9523
(606) 337-1832

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1804
KY
363AM0700X
Medical Physician Assistant
Primary
PA1804
KY
363AM0700X
Medical Physician Assistant
TC208
KY

Other

Enumeration date
07/24/2013
Last updated
12/08/2020
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