Individual
DR. BRIAN TIMOTHY BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 732-6440
Mailing address
2510 LYMAN AVE, MEDFORD, OR 97504-6917
(856) 287-7378
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO162360
OR
Other
Enumeration date
06/24/2009
Last updated
02/10/2017
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