Bonner, Jo Jaeger
Bonner, Jo Jaeger is an sole proprietor health care provider with primary practice located at 12680 Olive Blvd. Ste. 200, St. Louis MO 63141. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Bonner, Jo Jaeger can be contacted via phone (314) 251-8892.Contact Information
Primary practice address
12680 Olive Blvd. Ste. 200
St. Louis MO 63141
Phone: (314) 251-8892
Fax: (314) 251-8894
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 36705 | Missouri |
Profile Details
| NPI number | 1982701371 |
|---|---|
| LBN Legal business name | Bonner, Jo Jaeger |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jan 21st, 2010 - 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 | 1982701371 | NPPES |
| Missouri | MEDICAID | 010567402 |
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