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ROBERT JOSEPH BENNETT M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1053479402

Individual Registrant:
 ROBERT JOSEPH BENNETT M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
602 YALE PL  CANON CITY, CO 81212-4611 US
Tel: 719-275-2301  Fax: 719-275-7048

Contact information for business:
602 YALE PL  CANON CITY, CO 81212-4611 US
Tel: 719-275-2301  Fax: 719-275-7048

Registration Information:
NPI: 1053479402
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CO13841

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
01138411CO05




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