Provider Demographics
NPI:1386613719
Name:BENTLEY, PATRICK (DO)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:BENTLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 NEWFIELD CIR
Mailing Address - Street 2:246
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3856
Mailing Address - Country:US
Mailing Address - Phone:330-510-5011
Mailing Address - Fax:
Practice Address - Street 1:234 NEWFIELD CIR
Practice Address - Street 2:246
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3856
Practice Address - Country:US
Practice Address - Phone:330-510-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.006361B2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry