Individual
DR. BENJAMIN DOUGLAS BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2304 S WABASH AVE, KOKOMO, IN 46902-3319
(928) 486-1490
Mailing address
2304 S WABASH AVE, KOKOMO, IN 46902-3319
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1025072
IN
Other
Enumeration date
02/05/2012
Last updated
02/05/2012
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