Jack E Bonham, PA is a medicare enrolled "Physician Assistant" in Beech Grove, Indiana. His current practice location is
1600 Albany St, Beech Grove, Indiana. You can reach out to his office (for appointments etc.) via phone at
(317) 802-3151.
Jack E Bonham is licensed to practice in Indiana (license number 10001193A) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1396058608.
Provider's Profile
| Full Name | Jack E Bonham |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 1600 Albany St, Beech Grove, Indiana |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jack E Bonham attended and graduated from in
NPI Data:
- NPI Number: 1396058608
- Provider Enumeration Date: 07/16/2010
- Last Update Date: 06/25/2021
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Jack E Bonham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396058608 | NPI | - | NPPES |
| 300016938 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 10001193A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack E Bonham is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack E Bonham, PA
Po Box 7112, Dpt 31,
Indianapolis, IN 46207-7112
Ph: (317) 802-3151 | Jack E Bonham, PA
1600 Albany St,
Beech Grove, IN 46107-1541
Ph: (317) 802-3151 |
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