Bonnell, Mark Douglas

Bonnell, Mark Douglas is an individual health care provider with primary practice located at Santa Clara Health Center Rr 5 Box 446, Espanola NM 87532-8908. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Bonnell, Mark Douglas can be contacted via phone (505) 753-5039.

Contact Information

Primary practice address
Santa Clara Health Center Rr 5 Box 446 Espanola NM 87532-8908
Phone: (505) 753-5039
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 85-163 New Mexico
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 85-163 New Mexico

Profile Details

NPI number 1801872338
LBN Legal business name Bonnell, Mark Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated Nov 19th, 2007 - about 19 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.

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