Bennett, Thomas Omar
Bennett, Thomas Omar is an sole proprietor health care provider with primary practice located at 8679 Connecticut St Ste A, Merrillville IN 46410-6383. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bennett, Thomas Omar can be contacted via phone (219) 769-9022.Contact Information
Primary practice address
8679 Connecticut St Ste A
Merrillville IN 46410-6383
Phone: (219) 769-9022
Fax: (219) 769-1918
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 01030607A | Indiana |
Profile Details
| NPI number | 1427051911 |
|---|---|
| LBN Legal business name | Bennett, Thomas Omar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 27th, 2005 |
| Last updated | Mar 26th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427051911 | NPPES |
| Indiana | MEDICAID | 100167860 |
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