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1043086879
STEPHANIE FAYE BENNETT
MACON, GA
NPI
1043086879
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA RN251069)
Enumeration Date
2023-12-04
Last Update Date
2023-12-04
Business Address
Mrs. STEPHANIE FAYE BENNETT
101 GATEWAY DRIVE
MACON, GA 31210
Phone number: 478-210-1670
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Mailing Address
Mrs. STEPHANIE FAYE BENNETT
5661 OCMULGEE EAST BLVD
MACON, GA 31217-5797
Phone number: 478-960-9592
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