| Doctor Name: | WILLIAM SHAYNE BENNETT |
| NPI Number: | 1356735955 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN |
| License Number: | 3009174 |
| Business Practice Address: | 1107 Bellefonte Rd Flatwoods, KY - 411392503 |
| Business Phone Number: | 6068340125 |
| Business Fax Number: | 6068340128 |
| Mailing Address: | Po Box 1595, ASHLAND |
| State: | KY |
| Postal Code: | 411051595 |
| Phone Number: | 6064080417 |
| Fax Number: | 6064086069 |
| NPI Enumeration Date: | 03/23/2015 |
| NPI Last Update Date: | 03/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3009174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |