Doctor Name: | DR. WILLIAM RODERIC BENNETT |
NPI Number: | 1003179318 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 42 E. Laurel Rd, Udp Suite 2100a Stratford, NJ - 08084 |
Business Phone Number: | 8565666477 |
Business Fax Number: | |
Mailing Address: | 188 Fries Mill Rd, Suite N3 TURNERSVILLE |
State: | NJ |
Postal Code: | 080122015 |
Phone Number: | 6099373727 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2012 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |