Individual
DR. KERRY D. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3600 W BETHEL AVE, MUNCIE, IN 47304-5407
(765) 284-7738
(765) 213-3713
Mailing address
6280 S 625 W, PENDLETON, IN 46064-8972
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
02001168A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000209731
ANTHEM PIN
IN
01
—
200043532
RR MEDICARE
IN
05
—
200359010
—
IN
Enumeration date
07/31/2006
Last updated
11/13/2023
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