Benjamin, Bonna
Benjamin, Bonna is an individual health care provider with primary practice located at 1901 Medi Park Dr Ste 2051, Amarillo TX 79106-2169. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is her primary health care specialty. Benjamin, Bonna can be contacted via phone (806) 468-4300.Contact Information
Primary practice address
1901 Medi Park Dr Ste 2051
Amarillo TX 79106-2169
Phone: (806) 468-4300
Fax: (806) 468-4398
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | J8911 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | J8911 | Texas |
Profile Details
| NPI number | 1861408015 |
|---|---|
| LBN Legal business name | Benjamin, Bonna |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Jul 17th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861408015 | NPPES |
| Oklahoma | MEDICAID | 100027640A | |
| Oklahoma | MEDICAID | 124606807 | |
| Oklahoma | MEDICAID | J8716 | |
| Oklahoma | MEDICAID | 124606806 |
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