DR. MACK STUART BONNER MD NPI 1407857501

NPI Information

  • NPI: 1407857501
  • Provider Name: DR. MACK STUART BONNER, MD
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • Address: 590 S TRADE ST
    TRYON, NC
    ZIP 28782
  • Phone: (828) 859-0420

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NPI Details

DR. Mack Stuart Bonner, MD is a general practice in Tryon, NC. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Mack Stuart Bonner, MD NPI is 1407857501. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

590 S TRADE ST
TRYON, NC
ZIP 28782-714
Phone: (828) 859-0420
Fax: (828) 859-0422

The enumeration date for this NPI number is 8/10/2005 and was last updated on 3/15/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral Practice27125NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C828788112MEDICARE ID-TYPE UNSPECIFIEDSOUTH CAROLINA
22003715MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
32330350MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
4C82878MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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