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NPI Code Detail

MEDICARE: DR. PATRICK J BENNET D.O.

MEDICARE: DR. PATRICK J BENNET 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
12084P0800XPsychiatry PhysicianDO1924NV

General Provider Information

NPI Number : 1992094155
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK J BENNET D.O.
Provider Business Mailing Address
First Line : 3016 W CHARLESTON BLVD STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1964
Country : US
Telephone Number : 702-790-2701
Fax Number :
Provider Business Practice Location Address
First Line : 3016 W CHARLESTON BLVD STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1964
Country : US
Telephone Number : 702-790-2701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2011
Last Update Date : 11/02/2017

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