Kim D Bennett, DO | |
252 Rural Acres Dr, Beckley, WV 25801-3503 | |
(304) 252-8551 | |
(304) 252-1790 |
Full Name | Kim D Bennett |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 252 Rural Acres Dr, Beckley, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295827814 | NPI | - | NPPES |
3004166000 | Medicaid | WV | |
H90133 | Other | HEALTH NET | |
2145382 | Other | UNITEDHEALTHCARE | |
321488 | Other | CARELINK | |
54878 | Medicaid | WV | |
58941 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 1988 (West Virginia) | Primary |
Entity Name | Community Health Systems Inc |
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Entity Type | Part B Supplier - Public Health/welfare Agency |
Entity Identifiers | NPI Number: 1588738538 PECOS PAC ID: 6608785795 Enrollment ID: O20040311000504 |
Mailing Address | Practice Location Address |
---|---|
Kim D Bennett, DO 252 Rural Acres Dr, Beckley, WV 25801-3503 Ph: (304) 252-8551 | Kim D Bennett, DO 252 Rural Acres Dr, Beckley, WV 25801-3503 Ph: (304) 252-8551 |
Carlos Estanislao Lucero, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 403 Carriage Drive, Beckley, WV 25801 Phone: 304-255-7456 Fax: 304-255-5899 | |
Dr. Petaiah Mohan, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 194 Carriage Dr, Beckley, WV 25801 Phone: 304-255-6051 Fax: 304-255-6051 | |
Ramon Lacanilao, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30 Mallard Court, Beckley, WV 25801 Phone: 304-255-0800 Fax: 304-255-1040 | |
Dr. Michele Dawn Staton, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2401 S Kanawha St, Suite 110a, Beckley, WV 25801 Phone: 304-929-4646 Fax: 304-929-4649 | |
Dr. Malik Hamdan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1710 Harper Rd, Beckley, WV 25801 Phone: 304-256-4100 Fax: 304-254-3016 | |
Dr. Saraswathi Mohan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 194 Carriage Dr, Beckley, WV 25801 Phone: 304-255-6051 Fax: 304-255-6051 |