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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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
1	208D00000X	General Practice		27125	NORTH CAROLINA	Yes

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
1	C828788112	MEDICARE ID-TYPE UNSPECIFIED	SOUTH CAROLINA
2	2003715	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA
3	2330350	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA
4	C82878	MEDICARE 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: 4/28/2024

NPI Synchronization or Removal

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