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DR. CHARLES NELSON BENNETT MD
Adult Medicine >> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1659373330
Individual Registrant:DR. CHARLES NELSON BENNETT MD
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
301 S PALM AVE PALATKA, FL 32177-4143 US
Tel: 386-328-7493 Fax: 386-328-4137
Tel: 386-328-7493 Fax: 386-328-4137
Contact information for business:
301 S PALM AVE PALATKA, FL 32177-4143 US
Tel: 386-328-7493 Fax: 386-328-4137
Tel: 386-328-7493 Fax: 386-328-4137
Registration Information:
NPI: 1659373330
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207QA0505X | Allopathic & Osteopathic Physicians Family Medicine Adult Medicine | FL | 035737 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| AETNA | 7522348 | FL | 01 |
| 042618100 | FL | 05 |
