Bennett- Gittens, Raquel Lisa

Bennett- Gittens, Raquel Lisa is an individual health care provider with primary practice located at 610 19Th St , Columbus GA 31901-1528. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Bennett- Gittens, Raquel Lisa can be contacted via phone (706) 322-7884.

Contact Information

Primary practice address
610 19Th St Columbus GA 31901-1528
Phone: (706) 322-7884
Fax: (706) 660-2118
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 001688 Georgia
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 70713 Georgia

Profile Details

NPI number 1114191871
LBN Legal business name Bennett- Gittens, Raquel Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2008
Last updated Oct 5th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114191871 NPPES
Georgia Other 202I061193 MEDICARE PTAN
Georgia MEDICAID 003140208B MEDICARE PTAN

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