Healthcare Provider Details

I. General information

NPI: 1700065323
Provider Name (Legal Business Name): THE BOND GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 S COLLEGE RD SUITE 106
LAFAYETTE LA
70503-3060
US

IV. Provider business mailing address

913 S COLLEGE RD SUITE 106
LAFAYETTE LA
70503-3060
US

V. Phone/Fax

Practice location:
  • Phone: 337-264-7209
  • Fax: 337-264-7214
Mailing address:
  • Phone: 337-264-7209
  • Fax: 337-264-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberLA15178R
License Number StateLA

VIII. Authorized Official

Name: DR. THOMAS K BOND
Title or Position: OWNER
Credential: MD, MS
Phone: 337-264-7209