Provider Demographics
NPI:1932226735
Name:BENNETT, AARON AJAX (DO)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:AJAX
Last Name:BENNETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:183 N MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-4325
Mailing Address - Country:US
Mailing Address - Phone:231-398-1740
Mailing Address - Fax:231-398-1749
Practice Address - Street 1:1293 E PARKDALE AVE
Practice Address - Street 2:
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-8904
Practice Address - Country:US
Practice Address - Phone:231-398-1740
Practice Address - Fax:231-398-1749
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2020-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORDO166819208600000X
WAOP60458463208600000X
NY275163208600000X
MEDO2427208600000X
CT52913208600000X
NH16503208600000X
MN52743208600000X
MI5101016553208600000X
IADO04544208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery