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
Fax: (573) 449-3706
Website:

Health care specialties

SpecialtyCodeLicense #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 13 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 1407855778 NPPES
Missouri Other 180012949 RAILROAD MEDICARE
Missouri MEDICAID 202256202 RAILROAD MEDICARE

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