Individual
DR. BARRY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2775 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 524-5948
Mailing address
2775 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 524-5948
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-6374
ID
Other
Enumeration date
07/17/2006
Last updated
07/09/2007
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