Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK E BONHAM, PA
ActivePhysician Assistant · BEECH GROVE, IN
Registration Details
- NPI Number
- 1396058608
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 16, 2010 (15.778653596257 yrs)
- Last Updated
- Jun 25, 2021
- License
-
10001193A (IN)
Practice Information
- Address
-
1600 ALBANY STBEECH GROVE, IN, 461071541Browse IN providers · Browse ZIP 46107
- Phone
- 3178023151
- Fax
- 3178700499
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in BEECH GROVE, IN
| Name | Credential | NPI |
|---|---|---|
| ALEXANDRA SMITH | PA-C | 1225816366 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.