Individual
STANLEY R BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 N 12TH ST, PHOENIX, AZ 85006-2848
(602) 562-3012
(602) 282-9666
Mailing address
1300 N 12TH ST, PHOENIX, AZ 85006-2848
(602) 562-3012
(602) 282-9666
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15090
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171786
—
AZ
Enumeration date
01/12/2006
Last updated
02/09/2026
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