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Individual

DR. ROBERT U BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3555 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 875-3000
(417) 875-3176
Mailing address
3555 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 875-3000
(417) 875-3176

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R5749
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200405116
MO
01
R5749
STATE LICENSE
MO
Enumeration date
12/14/2005
Last updated
09/20/2012
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