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General NPI Number Information
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NPI Number | 1760410542
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Entity Type | Individual
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Provider Name | JON CHRISTOPHER BANWART MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 2900 MEDICAL CENTER PKWY STE 310
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City | BENTONVILLE
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State | AR
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Zip | 72712-3214
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Country | US
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Telephone | 479-553-3360
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Fax | 479-553-1911
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Provider Business Mailing Address
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Address Line | 2900 MEDICAL CENTER PKWY STE 310
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City | BENTONVILLE
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State | AR
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Zip | 72712-3214
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Country | US
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Telephone | 479-553-3360
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Fax | 479-553-1911
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 107602
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | E-19533
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 04-26856
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 29046
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License Number State | OK
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