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Individual

DR. CECIL FITZ ALBERT BENNETT JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
51 HOSPITAL RD, NEWNAN, GA 30263-1209
(770) 251-5540
(770) 251-5502
Mailing address
51 HOSPITAL RD, NEWNAN, GA 30263-1209
(770) 251-5540
(770) 487-9974

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048844
GA
207Q00000X
Family Medicine Physician
GA48844
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000932687A
GA
01
0225609
CIGNA
GA
01
08BBWCG
MEDICARE
GA
01
52841180
BCBSGA
GA
01
7275373
AETNA
GA
Enumeration date
11/07/2006
Last updated
10/02/2020
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