Bennett, Kerry D.

Bennett, Kerry D. is an individual health care provider with primary practice located at 3600 W Bethel Ave , Muncie IN 47304-5407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Bennett, Kerry D. can be contacted via phone (765) 284-7738.

Contact Information

Primary practice address
3600 W Bethel Ave Muncie IN 47304-5407
Fax: (765) 213-3713
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 02001168A Indiana

Profile Details

NPI number 1689680563
LBN Legal business name Bennett, Kerry D.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Nov 13th, 2023 - about last year

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 1689680563 NPPES
Indiana Other 200043532 RR MEDICARE
Indiana Other 000000209731 RR MEDICARE
Indiana MEDICAID 200359010 RR MEDICARE

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