NPI 1114903432 · live from the CMS NPI Registry
David G. Bennett, PA-C
Physician Assistant in Fallon, NV. National Provider Identifier 1114903432, active.
NPI record
| NPI | 1114903432 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 4755 Pasture Rd, Bldg 299, Fallon, NV 89496 |
| Practice phone | 775-426-2220 |
| Mailing address | 100 Brewster Blvd, Camp Lejeune, NC 28547 |
| Enumerated | December 19, 2005 |
| Last updated | July 2, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 0010-00159 (NC) |
| Physician Assistant primary | 363A00000X | PA11796 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.