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Individual

DR. CHRISTY M MOUNTAIN-BONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
601 FERNCREST DR STE B, SUITE B, SANDERSVILLE, GA 31082-1801
(478) 552-0006
Mailing address
PO BOX 935, SANDERSVILLE, GA 31082-0935
(478) 412-6522
(478) 412-6521

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
057222
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
057222
LICENSE NUMBER
GA
05
996007389B
GA
Enumeration date
09/14/2006
Last updated
03/04/2019
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