Individual
DR. HOUSTON GORDON BONNYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 SAINT CHARLES AVE FL 4, NEW ORLEANS, LA 70115-4637
(504) 897-8412
(504) 249-5311
Mailing address
3600 PRYTANIA ST STE 35, NEW ORLEANS, LA 70115-3678
(504) 897-8412
(504) 249-5311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
300355
LA
2086H0002X
Hospice and Palliative Medicine (Surgery) Physician
300355
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2418980
—
LA
Enumeration date
06/13/2011
Last updated
08/19/2024
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