Individual
JEFFREY SCOTT BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
910 BLACKFORD ST, CHATTANOOGA, TN 37403-1405
(423) 778-6107
(423) 778-6958
Mailing address
975 E 3RD ST, ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403-2147
(423) 778-6107
(423) 778-6958
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
54330
TN
2080P0208X
Pediatric Infectious Diseases Physician
54330
TN
Other
Enumeration date
06/02/2006
Last updated
08/01/2016
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