Individual
GREGORY THOMAS BONGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 N ROCK RD, DERBY, KS 67037-3705
(316) 788-6963
(316) 788-5373
Mailing address
1101 N ROCK RD, DERBY, KS 67037-3705
(316) 788-6963
(316) 788-5373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-26353
KS
Other
Enumeration date
04/20/2006
Last updated
07/14/2008
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