Individual
PAUL J. BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(434) 200-5898
(434) 200-7529
Mailing address
PO BOX 11646, LYNCHBURG, VA 24506-1646
(434) 200-5895
(424) 200-7529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
051867
GA
207R00000X
Internal Medicine Physician
0101247470
VA
208M00000X
Hospitalist Physician
Primary
0101247470
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00980746A
—
GA
05
—
1851305569
—
VA
Enumeration date
07/28/2006
Last updated
02/16/2023
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