Provider Demographics
NPI:1710958087
Name:BENNETT, ROBERT P (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:BENNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:262 NEIL AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2362
Mailing Address - Country:US
Mailing Address - Phone:614-228-4500
Mailing Address - Fax:614-384-2966
Practice Address - Street 1:262 NEIL AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2362
Practice Address - Country:US
Practice Address - Phone:614-228-4500
Practice Address - Fax:614-384-2966
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35038409207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0397388Medicaid
AB765654OtherDEA
AB765654OtherDEA
OHBE0461673Medicare ID - Type Unspecified