Organization
DANIEL C. BENNETT MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL CHRISTOPHER BENNETT MD (PHYSICIAN)
(903) 541-5171
Entity
Organization
Contact information
Practice address
501 S RAGSDALE ST, ETMC JACKSONVILLE RADIOLOGY DEPARTMENT, JACKSONVILLE, TX 75766-2434
(903) 541-5171
Mailing address
PO BOX 1681, JACKSONVILLE, TX 75766-1681
(903) 541-5171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K3092
TX
Other
Enumeration date
10/29/2008
Last updated
10/29/2008
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