| Jacob Bonilla, | |
|
1608 S. Kings Hwy, Douglas, AZ 85607 | |
| (520) 805-8162 | |
| Not Available |
| Full Name | Jacob Bonilla |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 1608 S. Kings Hwy, Douglas, Arizona |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417300096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Bonilla, 2817 Reilly St, Fort Bragg, NC 28310-8922 Ph: (910) 907-8922 | Jacob Bonilla, 1608 S. Kings Hwy, Douglas, AZ 85607 Ph: (520) 805-8162 |
Robert Snyder Rodriguez, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1100 F Ave, Douglas, AZ 85607 Phone: 520-364-3285 Fax: 520-364-4261 | |
Carlos Ernesto Pena, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 100 E 5th St, Douglas, AZ 85607 Phone: 520-364-7659 Fax: 520-364-8541 |