Provider Demographics
NPI:1912665860
Name:BOND, STEPHEN TAYLOR (RPH)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:TAYLOR
Last Name:BOND
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 N WILLIAMS CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-5831
Mailing Address - Country:US
Mailing Address - Phone:480-620-0664
Mailing Address - Fax:
Practice Address - Street 1:833 N WILLIAMS CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-5831
Practice Address - Country:US
Practice Address - Phone:480-260-0664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS007656333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD03559918OtherDRIVERS LICENCE