Individual
MARK R. BONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2205 MCCALLIE AVE, CHATTANOOGA, TN 37404-3230
(423) 698-2435
(423) 697-6173
Mailing address
2205 MCCALLIE AVE, CHATTANOOGA, TN 37404-3230
(423) 698-2435
(423) 697-6173
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
61345
TN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
61345
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3015767
—
OH
Enumeration date
09/21/2007
Last updated
01/31/2022
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