Individual
DR. TIMOTHY CHARLES BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1542 GOLF COURSE RD, SUITE 201, GRAND RAPIDS, MN 55744-9603
(218) 326-3433
(218) 326-3435
Mailing address
1542 GOLF COURSE RD, SUITE 201, GRAND RAPIDS, MN 55744-9603
(218) 326-3433
(218) 326-3435
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
27813
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225067500
—
MN
01
—
27813
STATE LICENSE
MN
Enumeration date
05/26/2006
Last updated
05/19/2015
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