Willard, Bennett L
Willard, Bennett L is an individual health care provider with primary practice located at 2060 E Paris Ave Se Ste 200 , Grand Rapids MI 49546-6113. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Willard, Bennett L can be contacted via phone (616) 285-1377.Contact Information
Primary practice address
2060 E Paris Ave Se Ste 200
Grand Rapids MI 49546-6113
Phone: (616) 285-1377
Fax: (616) 285-1154
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 5101008161 | Michigan |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 5101008161 | Michigan |
Profile Details
| NPI number | 1134186513 |
|---|---|
| LBN Legal business name | Willard, Bennett L |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 28th, 2006 |
| Last updated | May 6th, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134186513 | NPPES |
| Michigan | Other | 555410027 | BCBSM |
| Michigan | MEDICAID | 4610008-11 | BCBSM |
| Michigan | MEDICAID | 4535360-11 | BCBSM |
| Michigan | MEDICAID | 4609992-11 | BCBSM |
| Michigan | MEDICAID | 5212687-11 | BCBSM |
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