Healthcare Provider Details

I. General information

NPI: 1548189731
Provider Name (Legal Business Name): BENNETT PODIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23247 BRYANT PLAZA
BRYANT AR
72022
US

IV. Provider business mailing address

23247 I30 FRONTAGE RD STE 3
BRYANT AR
72022
US

V. Phone/Fax

Practice location:
  • Phone: 501-521-8318
  • Fax:
Mailing address:
  • Phone: 501-521-8318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD C BENNETT
Title or Position: OWNER
Credential: DPM
Phone: 313-982-9068