Individual
DR. GEORGE R BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6921 FRANKFORD AVE, SUITE # E, PHILADELPHIA, PA 19135-1623
(215) 624-0416
(215) 624-2770
Mailing address
6921 FRANKFORD AVE, SUITE E, PHILADELPHIA, PA 19135-1623
(215) 624-0416
(215) 624-2770
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000179
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133733
BLUE SHIELD
PA
01
—
137725ZBUV
GROUP MEMBER PROVIDER NUMBER
PA
Enumeration date
07/26/2006
Last updated
09/07/2012
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