Randall Paul Bennett, MD | |
104 27th Ave Se, Puyallup, WA 98374-1145 | |
(253) 770-9000 | |
(253) 770-9712 |
Full Name | Randall Paul Bennett |
---|---|
Gender | Male |
Speciality | Otolaryngology |
Location | 104 27th Ave Se, Puyallup, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619907953 | NPI | - | NPPES |
7078017 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Y00000X | Otolaryngology | MD22922 (Washington) | Primary |
Entity Name | Proliance Surgeons Inc Ps |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023170313 PECOS PAC ID: 8527972900 Enrollment ID: O20031119000128 |
Mailing Address | Practice Location Address |
---|---|
Randall Paul Bennett, MD Po Box 1205, Puyallup, WA 98371-0231 Ph: (253) 770-9000 | Randall Paul Bennett, MD 104 27th Ave Se, Puyallup, WA 98374-1145 Ph: (253) 770-9000 |
Dr. Todd Dwyer Jones, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 | |
Dr. Dennis R. Elonka, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 6415 82nd St E, Puyallup, WA 98371 Phone: 253-691-0823 | |
Vivian Mae Yu, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 | |
Christopher P. Lenkeit, DO Otolaryngology Medicare: Medicare Enrolled Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 | |
Julie Allina Gustafson, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-848-0368 Fax: 253-435-4937 | |
Douglas D Backous, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 104 27th Ave Se, Puyallup, WA 98374 Phone: 253-770-9000 Fax: 253-770-9712 |