Bennett, Justin A

Bennett, Justin A is an individual health care provider with primary practice located at 266 Joule St , Alcoa TN 37701-2422. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bennett, Justin A can be contacted via phone (865) 984-3864.

Contact Information

Primary practice address
266 Joule St Alcoa TN 37701-2422
Phone: (865) 984-3864
Fax: (865) 380-4095
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 52585 Tennessee

Profile Details

NPI number 1396011722
LBN Legal business name Bennett, Justin A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2012
Last updated May 1st, 2017 - about 8 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 1396011722 NPPES
Tennessee MEDICAID Q014187

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