Individual
SCOTT D BENNION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2546 E 2ND ST STE 400, CASPER, WY 82609-2062
(307) 234-0003
Mailing address
2546 E 2ND ST STE 400, CASPER, WY 82609-2062
(307) 234-0003
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
3201A
WY
207N00000X
Dermatology Physician
34844
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070014069
MEDICARE RAILROAD
WY
05
—
114196100
—
WY
05
—
37485865
—
CO
Enumeration date
08/01/2006
Last updated
10/15/2012
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