Doctor Name: | JERRY D BENNETT |
NPI Number: | 1699768119 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | F9192 |
Business Practice Address: | 706 Legend Ln Sherman, TX - 750925421 |
Business Phone Number: | 9038912139 |
Business Fax Number: | |
Mailing Address: | 500 N Highland Ave, SHERMAN |
State: | TX |
Postal Code: | 750927354 |
Phone Number: | 9038912139 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2005 |
NPI Last Update Date: | 02/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | F9192 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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. |