Provider Demographics
NPI:1346359155
Name:BONNER, HARVEY (OD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:BONNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2525 KING AVE W
Mailing Address - Street 2:VISION CENTER
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6425
Mailing Address - Country:US
Mailing Address - Phone:406-655-8280
Mailing Address - Fax:406-655-8281
Practice Address - Street 1:2525 KING AVE W
Practice Address - Street 2:VISION CENTER
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6425
Practice Address - Country:US
Practice Address - Phone:406-655-8280
Practice Address - Fax:406-655-8281
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT394OPT152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management