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General NPI Number Information
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NPI Number | 1770392425
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Entity Type | Organization
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Legal Business Name | BONNERS PRIMARY CARE LLC
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 2820 NAPOLEON AVE STE 990
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City | NEW ORLEANS
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State | LA
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Zip | 70115-8201
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Country | US
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Telephone | 504-347-1333
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Fax | 504-347-4755
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Provider Business Mailing Address
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Address Line | 2820 NAPOLEON AVE STE 990
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City | NEW ORLEANS
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State | LA
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Zip | 70115-8201
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Country | US
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Telephone | 504-383-9963
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Fax | 504-383-9963
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Authorized Official
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Title or Position | OWNER
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Name | KIRK LEE BONNER
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Credential | MD
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Telephone | 504-347-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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