NPI 1720065147 · live from the CMS NPI Registry
James S. Bonner, M.D.
Psychiatry & Neurology, Neurology in Ballwin, MO. National Provider Identifier 1720065147, active.
NPI record
| NPI | 1720065147 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 1354 Rusticview Dr, Ballwin, MO 63011 |
| Practice phone | 314-691-7488 |
| Enumerated | December 28, 2005 |
| Last updated | October 26, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | 36152 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.