Individual
DR. BENNIE BRET LAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
122 HIGHWAY 280, SUITE A, AMERICUS, GA 31719-8645
(229) 931-7156
(229) 931-9472
Mailing address
PO BOX 827, AMERICUS, GA 31709-0827
(229) 931-7156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
046879
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000840991B
—
GA
01
—
001223
BLUE CROSS BLUE SHEILD
GA
Enumeration date
02/01/2006
Last updated
11/21/2011
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