Individual
HARRY JOSEPH BONNAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
607 W DUE WEST AVE STE 102, MADISON, TN 37115-4420
(615) 868-2229
(615) 868-2432
Mailing address
601 NW ATLANTIC ST, TULLAHOMA, TN 37388-3536
(931) 393-5112
(931) 393-2247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20429
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083609481
NPI
TN
01
—
3000061
TULLAHOMA MEDICARE
TN
05
—
3000061
—
TN
01
—
3807797
MEDICARE OTHER
TN
05
—
3807797
—
TN
Enumeration date
09/13/2005
Last updated
11/17/2015
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