Woodall, Bonnie N.

Woodall, Bonnie N. is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as her primary health care specialty. Woodall, Bonnie N. can be contacted via phone (601) 984-2195.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-2195
Fax: (601) 815-1050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 11066 Mississippi

Profile Details

NPI number 1134155971
LBN Legal business name Woodall, Bonnie N.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Aug 15th, 2016 - about 9 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 1134155971 NPPES
Mississippi MEDICAID 00010725
Mississippi MEDICAID 1656631

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