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Individual

STEVEN BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1501 N CAMPBELL AVE, TUCSON, AZ 85724-5040
(520) 694-0111
Mailing address
1501 N CAMPBELL AVE STE 4401, TUCSON, AZ 85724-5114
(520) 626-7221
(520) 626-6943

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R77905
AZ
207R00000X
Internal Medicine Physician
R77905
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R77905
ARIZONA MEDICAL BOARD
AZ
Enumeration date
04/18/2020
Last updated
05/05/2021
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