Provider Demographics
NPI:1205826187
Name:BONDHUS, DALLAS M (PA)
Entity Type:Individual
Prefix:
First Name:DALLAS
Middle Name:M
Last Name:BONDHUS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DALLAS
Other - Middle Name:M
Other - Last Name:POMEROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-623-2426
Mailing Address - Fax:501-623-2405
Practice Address - Street 1:1 MERCY LN STE 505
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6462
Practice Address - Country:US
Practice Address - Phone:501-623-2426
Practice Address - Fax:501-623-2405
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA 294 AR363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical