Individual
DR. TIMOTHY L. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5520 COLLEGE BOULEVARD, SUITE 480, OVERLAND PARK, KS 66211
(913) 696-5000
(913) 696-5005
Mailing address
2401 GILLHAM ROAD, CHILDREN'S MERCY HOSPITALS AND CLINICS, KANSAS CITY, MO 64108
(816) 346-1343
(816) 234-9336
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
04-20677
KS
207VM0101X
Maternal & Fetal Medicine Physician
Primary
04-20677
KS
207VM0101X
Maternal & Fetal Medicine Physician
2008011473
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100160620B
—
KS
01
—
10865061
BCBS KANSAS CITY
MO
01
—
160035366
RR MEDICARE
—
01
—
625210
FIRSTGUARD
—
Enumeration date
08/30/2006
Last updated
11/19/2020
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