Individual
DR. RANDALL L BENNETT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 N WILMOT RD, TUCSON, AZ 85711-2602
(520) 872-7130
Mailing address
2202 N FORBES BLVD, TUCSON, AZ 85745-1412
(520) 872-7130
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23428
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359340
—
AZ
Enumeration date
07/21/2005
Last updated
07/08/2007
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