Individual
DR. NATHAN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9755 W STATE HIGHWAY 22, RATCLIFF, AR 72951-9000
(479) 635-5300
(479) 635-4700
Mailing address
PO BOX 130, RATCLIFF, AR 72951-0130
(479) 635-5300
(479) 635-4700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C6934
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112435003
—
AR
01
—
50443
AR BCBS
AR
Enumeration date
07/20/2006
Last updated
04/27/2017
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