Christopher Bennett, MD

Individual provider Active NPI Diagnostic Radiology Physician · Harrison, AR

NPI 1851310486 · NPPES record last updated Jan 2, 2014

Key facts

NPI
1851310486
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
C6369 (AR)
Practice address
620 N Main St
Harrison, AR 72601-2911
Phone
(479) 968-7930
Fax
(479) 968-1673
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X C6369 AR Yes

Addresses

Primary practice location

620 N Main St
Harrison, AR 72601-2911

Mailing address

PO Box 9178
Russellville, AR 72811-9178
Phone (479) 968-7930

Other identifiers

IdentifierTypeStateIssuer
105227001MedicaidAR
50414OtherARARKANSAS BCBS PROV#

Other providers in Harrison, AR

All providers in Harrison, AR · Diagnostic Radiology Physician in Arkansas

Sources for this page

Verify at the official NPI Registry.