Bennett, Kenneth R.

Bennett, Kenneth R. is an individual health care provider with primary practice located at 2500 North State Street Department Of Medicine Division Of Cardiology, Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Bennett, Kenneth R. can be contacted via phone (601) 984-5678.

Contact Information

Primary practice address
2500 North State Street Department Of Medicine Division Of Cardiology Jackson MS 39216-4500
Phone: (601) 984-5678
Fax: (601) 984-5638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 05908 Mississippi

Profile Details

NPI number 1043254253
LBN Legal business name Bennett, Kenneth R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jan 27th, 2016 - 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 1043254253 NPPES
Louisiana MEDICAID 1552470
Louisiana MEDICAID 180445
Louisiana Other RR 060049688
Louisiana MEDICAID 00119359
Louisiana Other P00462157

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