Benjamin, Bonna

Benjamin, Bonna is an individual health care provider with primary practice located at 1901 Medi Park Dr Ste 2051, Amarillo TX 79106-2169. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is her primary health care specialty. Benjamin, Bonna can be contacted via phone (806) 468-4300.

Contact Information

Primary practice address
1901 Medi Park Dr Ste 2051 Amarillo TX 79106-2169
Fax: (806) 468-4398
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X J8911 Texas
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X J8911 Texas

Profile Details

NPI number 1861408015
LBN Legal business name Benjamin, Bonna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Jul 17th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861408015 NPPES
Oklahoma MEDICAID 100027640A
Oklahoma MEDICAID 124606807
Oklahoma MEDICAID J8716
Oklahoma MEDICAID 124606806

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