Individual provider · Type 1 NPI

Brock Tanner Bennett, MD

Vascular Surgery Physician · Medford, OR

NPI number 1578092193 Active

Practice location

520 Medical Center Dr Ste 300
Medford, OR 97504-4316

Call (541) 930-8907 Map

Fax (541) 245-4820

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Vascular Surgery Physician Primary 2086S0129XMD218720 (OR)
Surgery Physician 208600000XMD218720 (OR)

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

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About NPI 1578092193

Brock Tanner Bennett, MD's National Provider Identifier is 1578092193, issued on Jun 7, 2017. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Medford, OR. The record was last updated on Jul 25, 2024.