Organization
BON NOLA, M.D. , LLC
Active
Organization
BON NOLA, M.D. , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOUNSAVATH NOLA M.D. (OWNER)
(316) 689-6004
Entity
Organization
Contact information
Practice address
804 S OLIVER AVE, WICHITA, KS 67218-2329
(316) 689-6004
(316) 613-2934
Mailing address
1431 S BLUFFVIEW DR, S-116, WICHITA, KS 67218-3039
(316) 689-6004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0424718
KS
Other
Enumeration date
11/28/2007
Last updated
12/11/2023
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