Individual
DR. RICHARD M BENNETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1270 N POST RD STE A, INDIANAPOLIS, IN 46219-4254
(317) 895-6095
(317) 895-6195
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 807-1262
(317) 859-4268
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01042286A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091691
ANTHEM PIN NUMBER
IN
01
—
100194370
GROUP MEDICAID NUMBER
IN
01
—
1487680518
GROUP NPI
IN
05
—
200003540
—
IN
Enumeration date
07/28/2006
Last updated
01/19/2024
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