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NPI Code Detail

MEDICARE: DR. BARBARA A BENNETT D.O.

MEDICARE: DR. BARBARA A BENNETT D.O.
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
1207Q00000XFamily Medicine Physician34003885BOH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5080191716OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1220226704OTHEROHDEPT. OF LABOR
2000000227853OTHEROHANTHEM
3000000227853OTHEROHUNICARE
4D0388508OTHEROHHUMANA/CHOICECARE
6421534506OTHEROHCHAMPUS/TRICARE
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
80120516OTHEROHUNITED HEALTH CARE
9421534506OTHEROHCIGNA
10421534506038OTHEROHCARESOURCE
1134003885OTHEROHMEDICAL LICENSE
12804387OTHEROHAETNA

General Provider Information

NPI Number : 1003819525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARBARA A BENNETT D.O.
Provider Business Mailing Address
First Line : 2912 SPRINGBORO RD W
Second Line : STE 201
City : DAYTON
State : OH
Zip : 45439-1674
Country : US
Telephone Number : 937-297-8999
Fax Number : 937-233-7605
Provider Business Practice Location Address
First Line : 8701 TROY PIKE STE 50
Second Line :
City : DAYTON
State : OH
Zip : 45424-1055
Country : US
Telephone Number : 937-233-4252
Fax Number : 937-233-7605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2005
Last Update Date : 04/25/2024

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