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General NPI Number Information
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NPI Number | 1730553918
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Entity Type | Organization
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Legal Business Name | BENNHOOK PLLC
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Dates
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Enumeration Date | 11/25/2015
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 3410 KIMBALL AVE
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City | WATERLOO
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State | IA
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Zip | 50702-5735
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Country | US
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Telephone | 319-233-3044
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1377
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City | WATERLOO
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State | IA
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Zip | 50704-1377
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL E RICHARDSON
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Credential | MD
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Telephone | 319-233-3044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD 35033
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License Number State | IA
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