Healthcare Provider Details

I. General information

NPI: 1083671002
Provider Name (Legal Business Name): JAMES P BOHNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

IU HEALTH PHYSICIANS BUILDING 820 SAMUEL MOORE PARKWAY
MOORESVILLE IN
46258-1794
US

IV. Provider business mailing address

950 N. MERIDIAN ST. STE. 500, PROVIDER ENROLLMENT
INDIANAPOLIS IN
46204-3908
US

V. Phone/Fax

Practice location:
  • Phone: 317-483-5000
  • Fax: 317-483-5050
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01042495A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01042495A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01042495A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: