Bonebrake, John S
Bonebrake, John S is an sole proprietor health care provider with primary practice located at 707 N 36Th St Suite A, Saint Joseph MO 64506-2968. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bonebrake, John S can be contacted via phone (816) 279-5683.Contact Information
Primary practice address
707 N 36Th St Suite A
Saint Joseph MO 64506-2968
Phone: (816) 279-5683
Fax: (816) 279-5685
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | T02478 | Missouri |
Profile Details
| NPI number | 1194724328 |
|---|---|
| LBN Legal business name | Bonebrake, John S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194724328 | NPPES |
| Missouri | MEDICAID | 311944706 | |
| Missouri | Other | 410048243 | |
| Missouri | Other | 108900 | |
| Missouri | Other | 200111698 |
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