Bennett, Brock Tanner

Bennett, Brock Tanner is an individual health care provider with primary practice located at 520 Medical Center Dr Ste 300 , Medford OR 97504-4316. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Bennett, Brock Tanner can be contacted via phone (541) 930-8907.

Contact Information

Primary practice address
520 Medical Center Dr Ste 300 Medford OR 97504-4316
Phone: (541) 930-8907
Fax: (541) 245-4820
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD218720 Oregon
Allopathic & Osteopathic Physicians / Surgery 208600000X MD218720 Oregon

Profile Details

NPI number 1578092193
LBN Legal business name Bennett, Brock Tanner
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2017
Last updated Jul 25th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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