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1912270117
THOMAS LAVELL BENNETT
PORTSMOUTH, VA
NPI
1912270117
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: VA 0101254422)
Enumeration Date
2012-02-17
Last Update Date
2021-12-07
Business Address
THOMAS LAVELL BENNETT
620 JOHN PAUL JONES CIRCLE NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708
Phone number: 757-953-2518
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Mailing Address
THOMAS LAVELL BENNETT
222 E 4TH ST
MOUNT VERNON, NY 10553-1414
Phone number: 978-968-9511
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