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General NPI Number Information
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NPI Number | 1487782322
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Entity Type | Organization
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Legal Business Name | BRETT R BENNION, MD, PC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 214 14TH AVE SW STE 101
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City | SIDNEY
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State | MT
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Zip | 59270-3521
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Country | US
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Telephone | 406-488-2380
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Fax | 406-488-2382
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Provider Business Mailing Address
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Address Line | 214 14TH AVE SW STE 101
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City | SIDNEY
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State | MT
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Zip | 59270-3521
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Country | US
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Telephone | 406-488-2380
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Fax | 406-488-2382
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Authorized Official
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Title or Position | OWNER
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Name | BRETT BENNION
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Credential | MD
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Telephone | 406-488-2380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 8624
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License Number State | MT
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