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General NPI Number Information
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NPI Number | 1720548183
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Entity Type | Individual
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Provider Name | JOSEPH GRADY BENNETT MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 4150 N MULBERRY DR
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City | KANSAS CITY
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State | MO
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Zip | 64116-1779
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Country | US
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Telephone | 913-588-1227
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Fax | 913-535-2214
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Provider Business Mailing Address
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Address Line | 4150 N MULBERRY DR
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City | KANSAS CITY
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State | MO
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Zip | 64116-1779
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Country | US
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Telephone | 913-588-1227
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Fax | 913-535-2214
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 04-50917
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 2025010867
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License Number State | MO
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