Provider Demographics
NPI:1396832846
Name:STEPHENS, BONNIE ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:ELIZABETH
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2827 FORT MISSOULA RD
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804
Mailing Address - Country:US
Mailing Address - Phone:406-327-4002
Mailing Address - Fax:208-625-5731
Practice Address - Street 1:2827 FORT MISSOULA RD
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804
Practice Address - Country:US
Practice Address - Phone:406-327-4002
Practice Address - Fax:208-625-5728
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM125432080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine