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NPI Code Detail

MEDICARE: DR. TODD C BONVALLET MD

MEDICARE: DR. TODD C BONVALLET MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0117XOrthopaedic Surgery of the Spine Physician42794GA

General Provider Information

NPI Number : 1952376337
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD C BONVALLET MD
Provider Business Mailing Address
First Line : 6262 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-3540
Country : US
Telephone Number : 706-324-6661
Fax Number : 706-494-3306
Provider Business Practice Location Address
First Line : 6262 VETERANS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-3540
Country : US
Telephone Number : 706-324-6661
Fax Number : 706-494-3306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 02/26/2021

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