Individual
JONATHAN BENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
028081
TN
207L00000X
Anesthesiology Physician
Primary
28081
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3057887
BCBS PROVIDER NUMBER
TN
05
—
3802014
—
TN
05
—
64721558
—
KY
Enumeration date
06/17/2005
Last updated
08/20/2008
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