Organization
NILAH NICOLE BONHAM OD PC
Active
Other names
Eyecare Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NILAH NICOLE BONHAM OD (OWNER)
(812) 443-0060
Entity
Organization
Contact information
Practice address
325 W NATIONAL AVE, BRAZIL, IN 47834-2542
(812) 443-0060
Mailing address
325 W NATIONAL AVE, BRAZIL, IN 47834-2542
(812) 443-0060
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6024820001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6024820001
MEDICARE PTAN
IN
Enumeration date
04/25/2008
Last updated
04/25/2008
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