Organization
BONNER MEDICAL HAIR GROUP INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNNY LEE BONNER SR. MD (DOCTOR)
(256) 457-3071
Entity
Organization
Contact information
Practice address
4600 ROSWELL RD, ATLANTA, GA 30342-3075
(256) 457-3071
Mailing address
4310 BRONTE LN, DOUGLASVILLE, GA 30135-4981
(256) 457-3071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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