Provider Demographics
NPI:1780656819
Name:BONDS, TERRY L (OD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:BONDS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 PELHAM RD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-2745
Mailing Address - Country:US
Mailing Address - Phone:256-435-9453
Mailing Address - Fax:256-435-9485
Practice Address - Street 1:601 PELHAM RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-2745
Practice Address - Country:US
Practice Address - Phone:256-435-9453
Practice Address - Fax:256-435-9485
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS491-TA-015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000058372Medicare PIN