MR. JACK DAVID BENNETT M.D. NPI 1518167550

NPI Information

NPI: 1518167550
Provider Name: MR. JACK DAVID BENNETT, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
617 S MARKET ST
#2
WAVERLY, OH
ZIP 45690
Phone: (740) 941-1859
Get Directions

MR. Jack David Bennett, M.D. is a pediatrics in Waverly, OH. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MR. Jack David Bennett, M.D. NPI is 1518167550. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

617 S MARKET ST
#2
WAVERLY, OH
ZIP 45690-654
Phone: (740) 941-1859
Fax: (740) 941-1859

The enumeration date for this NPI number is 7/18/2007 and was last updated on 7/18/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		35067134	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	F92648	MEDICARE UPIN
2	0986429	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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