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Individual

DR. JAMES GRADY BENNETT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
970 LAKELAND DR, SUITE 61, JACKSON, MS 39216-4635
(601) 982-7850
(601) 718-5145
Mailing address
970 LAKELAND DR, SUITE 61, JACKSON, MS 39216-4635
(601) 982-7850
(601) 718-5145

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
16464
MS
207RI0011X
Interventional Cardiology Physician
Primary
16464
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03650034
MS
Enumeration date
06/15/2006
Last updated
11/15/2023
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