Individual
TIMOTHY JOHN BONATUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1485 N TURQUOISE DR, STE 200, FLAGSTAFF, AZ 86001-1398
(928) 774-7757
(928) 226-3071
Mailing address
1485 N TURQUOISE DRIVE, FLAGSTAFF, AZ 86001
(928) 774-7757
(928) 226-3071
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2691
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137952
—
AZ
Enumeration date
01/31/2006
Last updated
04/17/2019
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