Individual
DR. BRETT ASHLEY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
970 LAKELAND DR, STE 61, JACKSON, MS 39216-4634
(601) 982-7850
(601) 366-8507
Mailing address
970 LAKELAND DR, STE 61, JACKSON, MS 39216-4634
(601) 982-7850
(601) 366-8507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-2285
MS
207RC0000X
Cardiovascular Disease Physician
22329
MS
207RI0011X
Interventional Cardiology Physician
Primary
22329
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22329
MEDICAL LICENSE
MS
Enumeration date
07/02/2010
Last updated
11/15/2023
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