Individual
DR. EVERETT J. BONNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7373 PERKINS RD., BATON ROUGE CLINIC - ATTN: DEE - ADMINISTRATION, BATON ROUGE, LA 70808-4326
(225) 769-4044
Mailing address
7373 PERKINS RD, BATON ROUGE, LA 70808-4373
(225) 246-9790
(225) 246-9100
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
054561
GA
2086S0129X
Vascular Surgery Physician
Primary
201869
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1076392
—
LA
Enumeration date
10/29/2006
Last updated
01/27/2021
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