Healthcare Provider Details

I. General information

NPI: 1730120551
Provider Name (Legal Business Name): JAMES W BONDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EAST HIGHWAY 262
MONTEZUMA CREEK UT
84534-0130
US

IV. Provider business mailing address

PO BOX 130
MONTEZUMA CREEK UT
84534-0130
US

V. Phone/Fax

Practice location:
  • Phone: 435-651-3701
  • Fax:
Mailing address:
  • Phone: 435-651-3701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number85653028017
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: