Smith, Bonnie R
Smith, Bonnie R is an individual health care provider with primary practice located at 1241 W Stadium Blvd , Jefferson City MO 65109-6023. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Smith, Bonnie R can be contacted via phone (573) 556-7755.Contact Information
Primary practice address
1241 W Stadium Blvd
Jefferson City MO 65109-6023
Phone: (573) 556-7755
Fax: (573) 761-3599
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 2005020853 | Missouri |
Profile Details
| NPI number | 1073554267 |
|---|---|
| LBN Legal business name | Smith, Bonnie R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Feb 12th, 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 | 1073554267 | NPPES |
| Missouri | Other | P00317767 | RAILROAD MEDICARE |
| Missouri | Other | 751486 | RAILROAD MEDICARE |
| Missouri | MEDICAID | 200396604 | RAILROAD MEDICARE |
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