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NPI Code Detail

MEDICARE: RUTH SHERMAN BENNETT DO

MEDICARE: RUTH SHERMAN BENNETT DO
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
1207P00000XEmergency Medicine PhysicianA-1446-08NM
2207Q00000XFamily Medicine PhysicianA-1446-08NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205802956
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH SHERMAN BENNETT DO
Provider Business Mailing Address
First Line : 71 KINGSTON MAIN ST
Second Line :
City : HILLSBORO
State : NM
Zip : 88042
Country : US
Telephone Number : 575-740-8169
Fax Number : 405-553-5633
Provider Business Practice Location Address
First Line : 1313 E 32ND ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-7251
Country : US
Telephone Number : 575-538-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 10/28/2019

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