NPI 1336199751 · live from the CMS NPI Registry
Jack W. Bonner, M.D.
Psychiatry & Neurology, Psychiatry in Greenville, SC. National Provider Identifier 1336199751, active.
NPI record
| NPI | 1336199751 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Psychiatry 2084P0800X |
| Practice location | 701 Grove Rd, Greenville, SC 29605 |
| Practice phone | 864-455-8431 |
| Mailing address | 7 Independence PT, Suite 140, Greenville, SC 29615 |
| Enumerated | May 10, 2006 |
| Last updated | December 28, 2009 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Psychiatry primary | 2084P0800X | 17455 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.