Individual
DR. JOSHUA LEITCH BONKOWSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 662-1000
(801) 587-7539
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4979065-1205
UT
2084N0400X
Neurology Physician
4979065-1205
UT
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
4979065-1205
UT
Other
Enumeration date
05/23/2006
Last updated
06/15/2026
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