Healthcare Provider Details

I. General information

NPI: 1831401389
Provider Name (Legal Business Name): CLIFFORD L BOND MDIV
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5847 SW 29TH ST
TOPEKA KS
66614-2462
US

IV. Provider business mailing address

4201 NW FIELDING RD
TOPEKA KS
66618-2628
US

V. Phone/Fax

Practice location:
  • Phone: 785-273-7292
  • Fax: 785-273-1201
Mailing address:
  • Phone: 785-286-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: