Doctor Name: | DR. JAMES ROALD BENNION |
NPI Number: | 1396739637 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | M-6004 |
Business Practice Address: | 79 Mdg Chief, Medical Staff 1050 West Perimeter Rd Andrews Afb, MD - 207626601 |
Business Phone Number: | 2408578811 |
Business Fax Number: | |
Mailing Address: | 79 Mdg Chief, Medical Staff, 1050 West Perimeter Rd ANDREWS AFB |
State: | MD |
Postal Code: | 207626601 |
Phone Number: | 2408578811 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2083P0500X |
License Number: | M-6004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Preventive Medicine |
Taxonomy Specialization: | Preventive Medicine/Occupational Environmental Medicine |
Taxonomy Definition: | A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |