Individual
JOSEPH BONVILLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19343 SUNSHINE AVE, COVINGTON, LA 70433-8834
(985) 892-5117
(985) 892-5128
Mailing address
19343 SUNSHINE AVE, COVINGTON, LA 70433-8834
(985) 892-5117
(985) 892-5128
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
303155
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2102885
—
LA
Enumeration date
05/03/2010
Last updated
01/31/2017
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