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General NPI Number Information
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NPI Number | 1811211063
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Entity Type | Organization
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Legal Business Name | PCRMC - BOND CLINIC MEDICAL GROUP
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 600 BLUES LAKE PKWY
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City | ROLLA
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State | MO
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Zip | 65401-8022
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Country | US
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Telephone | 573-364-8822
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Fax | 573-341-5969
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Provider Business Mailing Address
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Address Line | 600 BLUES LAKE PKWY
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City | ROLLA
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State | MO
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Zip | 65401-8022
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Country | US
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Telephone | 573-364-8822
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Fax | 573-341-5969
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CATHY BOND
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Credential | D.O.
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Telephone | 573-364-8822
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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 | R8583
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30610
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R7D34
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | R7812
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 114610
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2006036024
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License Number State | MO
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Taxonomy #7
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 119445
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License Number State | MO
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Taxonomy #8
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 2001015853
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License Number State | MO
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Taxonomy #9
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 117468
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License Number State | MO
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Taxonomy #10
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 112148
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License Number State | MO
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Taxonomy #11
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2006005292
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License Number State | MO
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Taxonomy #12
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2006001740
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License Number State | MO
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Taxonomy #13
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 128892
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License Number State | MO
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Taxonomy #14
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2002005692
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License Number State | MO
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Taxonomy #15
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 116667
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License Number State | MP
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