Organization
SARITA L BENNETT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARITA L BENNETT DO (OWNER)
(304) 799-0011
Entity
Organization
Contact information
Practice address
RT 2 BOX 386, MARLINTON, WV 24954-9743
(304) 799-0011
(304) 799-0035
Mailing address
RT 2 BOX 386, MARLINTON, WV 24954-9743
(304) 799-0011
(304) 799-0035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1755
WV
208D00000X
General Practice Physician
Primary
1755
WV
251B00000X
Case Management Agency
1755
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4902001000
—
WV
05
—
5600573000
—
WV
Enumeration date
05/31/2007
Last updated
03/06/2012
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