Individual
FLETCHER K BENNETT-GAYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
3742 WINTERFIELD RD, MIDLOTHIAN, VA 23113-9238
(804) 330-3335
(804) 330-9205
Mailing address
3742 WINTERFIELD RD, MIDLOTHIAN, VA 23113-9238
(804) 330-3335
(804) 330-9205
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0110001514
VA
363A00000X
Physician Assistant
005805
NY
363A00000X
Physician Assistant
Primary
0110001514
VA
363A00000X
Physician Assistant
MP634
NJ
Other
Enumeration date
07/14/2006
Last updated
12/13/2010
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