Provider Demographics
NPI:1003819525
Name:BENNETT, BARBARA A (DO)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:BENNETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2912 SPRINGBORO RD W
Mailing Address - Street 2:STE 201
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1674
Mailing Address - Country:US
Mailing Address - Phone:937-297-8999
Mailing Address - Fax:937-233-7605
Practice Address - Street 1:8701 TROY PIKE STE 50
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-1055
Practice Address - Country:US
Practice Address - Phone:937-233-4252
Practice Address - Fax:937-233-7605
Is Sole Proprietor?:No
Enumeration Date:2005-05-30
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003885B207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH220226704OtherDEPT. OF LABOR
OH000000227853OtherANTHEM
OH000000227853OtherUNICARE
OHD0388508OtherHUMANA/CHOICECARE
OH080191716OtherRAILROAD MEDICARE
OH421534506OtherCHAMPUS/TRICARE
OH0632588Medicaid
OH0120516OtherUNITED HEALTH CARE
OH421534506OtherCIGNA
OH421534506038OtherCARESOURCE
OH34003885OtherMEDICAL LICENSE
OH804387OtherAETNA
OH0632588Medicaid
OHBE0585076Medicare PIN
OH0632588Medicaid