Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 04-29549 | KS |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0429549 | KS |
NPI | 1760486674 |
---|---|
Provider Name | Dr. Susan K Bonar |
First Address | Leawood, KS 66211-1655 |
Second Address | Leawood, KS 66211-1655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 29/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202879427 | ADVANTRA (01) | MO |
202879427 | CIGNA (01) | MO |
202879427 | COVENTRY (01) | MO |
202879427 | HUMANA (01) | |
202879727 | GREAT WEST HEALTHCARE (01) | |
207754219 | (05) | MO |
21386021 | BCBS OF KC (01) | MO |
5778210 | AETNA (01) | MO |
F96678 | (02) |