Bonham, Roger D
Bonham, Roger D is an individual health care provider with primary practice located at 500 N Keene St Suite 101, Columbia MO 65201-8104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bonham, Roger D can be contacted via phone (573) 449-3846.Contact Information
Primary practice address
500 N Keene St Suite 101
Columbia MO 65201-8104
Phone: (573) 449-3846
Fax: (573) 449-3706
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | R6F35 | Missouri |
Profile Details
| NPI number | 1407855778 |
|---|---|
| LBN Legal business name | Bonham, Roger D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Aug 19th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407855778 | NPPES |
| Missouri | Other | 180012949 | RAILROAD MEDICARE |
| Missouri | MEDICAID | 202256202 | RAILROAD MEDICARE |
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