Individual
CARROLL GENE BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 S NATIONAL AVE STE 700, SPRINGFIELD, MO 65807-5279
(417) 269-8817
Mailing address
3800 S NATIONAL AVE STE 700, SPRINGFIELD, MO 65807-5279
(417) 269-8817
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2025021649
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
05/13/2026
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