Organization
DAN BENNETT, M.D., P.A.
Active
Other names
Bennett Ophthalmology Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARSHA P WARD (CLINIC MANAGER)
(662) 328-1254
Entity
Organization
Contact information
Practice address
2475 5TH ST N, COLUMBUS, MS 39705-2005
(662) 328-1254
(662) 327-2033
Mailing address
2475 5TH ST N, COLUMBUS, MS 39705-2005
(662) 328-1254
(662) 327-2033
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12818
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08101054
—
MS
01
—
CM6726
RR MEDICARE
GA
Enumeration date
05/13/2007
Last updated
02/18/2008
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