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NPI Code Detail

MEDICARE: RICHARD L BENNETT M.D.

MEDICARE: RICHARD L BENNETT M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LA0401XAddiction Medicine (Anesthesiology) Physician20182KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447252168
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD L BENNETT M.D.
Provider Business Mailing Address
First Line : 2121 RICHMOND RD STE 221
Second Line :
City : LEXINGTON
State : KY
Zip : 40502-1213
Country : US
Telephone Number : 859-396-4346
Fax Number : 859-269-4120
Provider Business Practice Location Address
First Line : 1740 NICHOLASVILLE RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-1431
Country : US
Telephone Number : 859-260-2198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 04/10/2024

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