Provider Demographics
NPI:1003943416
Name:BOND, JOHN A (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:BOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4420 IRVING BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5915
Mailing Address - Country:US
Mailing Address - Phone:505-727-6300
Mailing Address - Fax:505-727-9588
Practice Address - Street 1:4420 IRVING BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5915
Practice Address - Country:US
Practice Address - Phone:505-727-6300
Practice Address - Fax:505-727-9588
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26393207Q00000X, 207QG0300X
NMMD2015-0638207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64263932Medicaid
KY64263932Medicaid
KY64263932Medicaid