Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH J BENNETT, MD
Active Sole ProprietorKENNETH J BENNETT, MD is a Specialist healthcare provider located in ST LOUIS, Missouri. NPI 1528257698 is currently active in the NPPES registry. Verify at CMS.
Specialist · ST LOUIS, MO
Registration Details
- NPI Number
- 1528257698
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 15, 2007 (18.686773467986 yrs)
- Last Updated
- Aug 6, 2009
- License
-
R4131 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1040 N MASON RDSTE G-03ST LOUIS, MO, 63141Browse MO providers · Browse ZIP 63141
- Phone
- 3148787899
- Fax
- 3142051020
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in ST LOUIS, MO
| Name | Credential | NPI |
|---|---|---|
| FARRIS JACKSON JR. | MD | 1083618904 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.