Mr Jack David Bennett, MD is a
Pediatrics physician based in Waverly, Ohio. Mr Jack David Bennett is licensed to practice in Ohio (license number 35067134) and his current practice location is 617 S Market St, #2, Waverly, Ohio. He can be reached at his office (for appointments etc.) via phone at
(740) 941-1859.
NPI number for Mr Jack David Bennett is 1518167550 and his current mailing address is 617 S Market St, #2, Waverly, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1518167550.
Physician's Profile
| Full Name | Mr Jack David Bennett |
|---|
| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 617 S Market St, Waverly, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1518167550
- Provider Enumeration Date: 07/18/2007
- Last Update Date: 07/18/2007
Medical Identifiers
Medical identifiers for Mr Jack David Bennett such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518167550 | NPI | - | NPPES |
| 0986429 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 35067134 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jack David Bennett is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jack David Bennett, MD
617 S Market St, #2,
Waverly, OH 45690-1654
Ph: (740) 941-1859 | Mr Jack David Bennett, MD
617 S Market St, #2,
Waverly, OH 45690-1654
Ph: (740) 941-1859 |
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