Individual
CHRISTOPHER BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 N MAIN ST, HARRISON, AR 72601-2911
(479) 968-7930
(479) 968-1673
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(479) 968-7930
(479) 968-1673
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C6369
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105227001
—
AR
01
—
50414
ARKANSAS BCBS PROV#
AR
Enumeration date
07/18/2006
Last updated
01/02/2014
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