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Organization

BONNER AND HAITHCOCK, MD.'S , LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LAVONDA NIQUITA HURT (INSURANCE,BILLING COORDINATOR)
(804) 644-1333
Entity
Organization

Contact information

Practice address
505 W LEIGH ST, SUITE 303, RICHMOND, VA 23220-3200
(804) 644-1333
(804) 782-1193
Mailing address
505 W. LEIGH STREET, SUITE 303, RICHMOND, VA 23220
(804) 644-1333
(804) 782-1193

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6078401
VA
05
6078460
VA
Enumeration date
07/13/2006
Last updated
09/22/2010
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