Doctor Name: | GARRISON S. BENNETT |
NPI Number: | 1114990009 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 0101102655 |
Business Practice Address: | 15769 Wc Main St Midlothian, VA - 231137327 |
Business Phone Number: | 8044199760 |
Business Fax Number: | 8043789140 |
Mailing Address: | 3000 Watercove Rd, MIDLOTHIAN |
State: | VA |
Postal Code: | 23112 |
Phone Number: | 8047448140 |
Fax Number: | 8047447390 |
NPI Enumeration Date: | 02/10/2006 |
NPI Last Update Date: | 07/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0101102655 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |