Individual
ZACHARY D BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
151 ADAMS LN STE 18, MT JULIET, TN 37122-8320
(615) 453-8999
Mailing address
3401 FAWNWOOD PL, NASHVILLE, TN 37207-2182
(419) 296-2815
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA0000002770
TN
363A00000X
Physician Assistant
Primary
PA9107032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008199500
—
FL
Enumeration date
01/17/2013
Last updated
03/05/2019
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