Dr. Bennett Blum, MD

in Tucson, AZ. Individual provider (NPI-1).

NPI number1124322151

StatusActive

Last updated in NPPESJan 5, 2011

Details

NPI: 1124322151
Entity type: Individual (NPI-1)
Name: Dr. Bennett Blum
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Jan 5, 2011
Last updated: Jan 5, 2011

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2084P0805X		27112	AZ	Yes
2084F0202X	Psychiatry & Neurology, Forensic Psychiatry	27112	AZ
2084F0202X	Psychiatry & Neurology, Forensic Psychiatry	G72139	CA
2084P0800X	Psychiatry & Neurology, Psychiatry	G72139	CA
2084P0805X		G72139	CA
208D00000X	General Practice	27112	AZ
208D00000X	General Practice	G72139	CA

Practice location

5425 E Broadway Blvd
Pmb #358
Tucson, AZ 85711-3704

Phone 520-990-4145

Mailing address

5425 E Broadway Blvd
Pmb #358
Tucson, AZ 85711-3704

Phone 520-990-4145

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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