Individual
AUDREY K BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4266
(220) 564-4166
Mailing address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4266
(220) 564-4166
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35.091696
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649499260
—
VA
05
—
2848495
—
OH
Enumeration date
04/24/2007
Last updated
09/13/2016
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