MEDICARE: DR. PHILLIP WASHBURN BENNION M.D.

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
1	207X00000X	Orthopaedic Surgery Physician	40310	AZ

General Provider Information

NPI Number	:	1982727590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP WASHBURN BENNION M.D.

Provider Business Mailing Address
First Line	:	2122 E HIGHLAND AVE
Second Line	:	SUITE300
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4739
Country	:	US
Telephone Number	:	602-553-3113
Fax Number	:	602-667-7991

Provider Business Practice Location Address
First Line	:	2122 E HIGHLAND AVE
Second Line	:	SUITE 300
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4739
Country	:	US
Telephone Number	:	602-553-3113
Fax Number	:	602-667-7991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	06/11/2008

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