Organization
PAUL V. BONETZKY DO
Active
Other names
DR. PAUL V. BONETZKY INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEAN P BONETZKY (PRACTICE ADMINISTRATOR)
(937) 843-5000
Entity
Organization
Contact information
Practice address
8200 STATE ROUTE 366, RUSSELLS POINT, OH 43348-9670
(937) 843-5000
Mailing address
8200 STATE ROUTE 366, RUSSELLS POINT, OH 43348-9670
(937) 843-5000
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004228178
AETNA
OH
05
—
0833889
—
OH
01
—
34001524
STATE MEDICAL LISC.
OH
01
—
A68388
UPIN
OH
Enumeration date
05/03/2007
Last updated
07/21/2022
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