Bonine, Timothy Ray
Bonine, Timothy Ray is an individual health care provider with primary practice located at 1309 Ponderosa Dr Suite 103, Sandpoint ID 83864-8278. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bonine, Timothy Ray can be contacted via phone (208) 263-9545.Contact Information
Primary practice address
1309 Ponderosa Dr Suite 103
Sandpoint ID 83864-8278
Phone: (208) 263-9545
Fax: (208) 263-9539
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M8424 | Idaho |
Profile Details
| NPI number | 1215900865 |
|---|---|
| LBN Legal business name | Bonine, Timothy Ray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Feb 19th, 2008 - about 16 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 | 1215900865 | NPPES |
| Idaho | MEDICAID | 8063566200 |
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