Bennett, Myla Nicole

Bennett, Myla Nicole is an individual health care provider with primary practice located at 1911 Chester Blvd , Richmond IN 47374-1212. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as her primary health care specialty. Bennett, Myla Nicole can be contacted via phone (765) 962-4872.

Contact Information

Primary practice address
1911 Chester Blvd Richmond IN 47374-1212
Phone: (765) 962-4872
Fax: (765) 935-8913
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 35.097053 Ohio
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 01070339A Indiana

Profile Details

NPI number 1194935536
LBN Legal business name Bennett, Myla Nicole
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jan 9th, 2015 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1194935536 NPPES
Indiana MEDICAID 201040990
Indiana MEDICAID 0051083
Indiana Other 000000738583

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