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NPI Code Detail

MEDICARE: DR. THOMAS L BENNETT M.D.

MEDICARE:  DR. THOMAS 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician8418MT

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 : 1598769820
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS L BENNETT M.D.
Provider Business Mailing Address
First Line : 4549 PALISADES PARK DR
Second Line :
City : BILLINGS
State : MT
Zip : 59106-1340
Country : US
Telephone Number : 406-237-5447
Fax Number : 406-237-8024
Provider Business Practice Location Address
First Line : 4549 PALISADES PARK DR
Second Line :
City : BILLINGS
State : MT
Zip : 59106-1340
Country : US
Telephone Number : 406-237-5447
Fax Number : 406-237-8024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 02/27/2008

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