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Individual

DR. FREEMAN T BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1203 LINDEN PL, JACKSON, MS 39202-2102
(601) 594-6997
(888) 506-2638
Mailing address
1203 LINDEN PL, JACKSON, MS 39202-2102
(601) 594-6997
(888) 506-2638

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14442
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01888820
MS
05
09015768
MS
01
PROVIDER NO. 8EB240
CMS
Enumeration date
06/16/2006
Last updated
01/23/2013
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