Individual provider · NPI-1

Kimberly Jo Bennett, D.O.

Hospitalist · Tulsa, OK

NPI number1255317871
StatusActive
Last updated in NPPESNov 11, 2021

Details

NPI
1255317871
Entity type
Individual (NPI-1)
Name
Kimberly Jo Bennett
Credential
D.O.
Sex
Female
Sole proprietor
No
Enumeration date
Dec 15, 2005
Certification date
Nov 11, 2021
Last updated
Nov 11, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208M00000X Hospitalist4036OKYes
207R00000X Internal Medicine4036OK

Practice location

6161 S Yale Ave
Tulsa, OK 74136-1902

Phone 918-494-5346 · Fax 918-494-6303

Mailing address

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136-3310

Phone 918-488-6001 · Fax 918-488-6010

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