Individual
SCOTT BLANTON BENNION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4600
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8526
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
073399
GA
207P00000X
Emergency Medicine Physician
5101017192
MI
207P00000X
Emergency Medicine Physician
Primary
72678
WI
Other
Enumeration date
07/13/2007
Last updated
07/31/2023
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