Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 34003885B | OH |
NPI | 1003819525 |
---|---|
Provider Name | Dr. Barbara A Bennett |
First Address | Dayton, OH 45439-1674 |
Second Address | Huber Heights, OH 45424-1055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2005 |
Last Update Date | 22/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000227853 | ANTHEM (01) | OH |
000000227853 | UNICARE (01) | OH |
0120516 | UNITED HEALTH CARE (01) | OH |
0632588 | (05) | OH |
080191716 | RAILROAD MEDICARE (01) | OH |
220226704 | DEPT. OF LABOR (01) | OH |
34003885 | MEDICAL LICENSE (01) | OH |
421534506 | CHAMPUS/TRICARE (01) | OH |
421534506 | CIGNA (01) | OH |
421534506038 | CARESOURCE (01) | OH |
804387 | AETNA (01) | OH |
A16497 | (02) | |
D0388508 | HUMANA/CHOICECARE (01) | OH |