Provider Demographics
NPI:1528005667
Name:BENNETT, RICK LEE (MD)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:LEE
Last Name:BENNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-7260
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 330
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205
Practice Address - Country:US
Practice Address - Phone:615-269-4545
Practice Address - Fax:615-565-6789
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24393207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6011578OtherBCBS
TNP00449690OtherRR MEDICARE
TN103I069305Medicare PIN
TN6011578OtherBCBS
TNF65165Medicare UPIN