Provider Demographics
NPI:1447247218
Name:GOINS, BONNIE K (MD)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:K
Last Name:GOINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:902 N RIVERSIDE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2566
Mailing Address - Country:US
Mailing Address - Phone:816-271-7280
Mailing Address - Fax:816-271-1047
Practice Address - Street 1:902 N RIVERSIDE RD
Practice Address - Street 2:#201
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2559
Practice Address - Country:US
Practice Address - Phone:816-271-7280
Practice Address - Fax:816-271-1047
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1002702085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO21473026OtherBCBS
MO203823505Medicaid
P00092604OtherRR MEDICARE
P00092604OtherRR MEDICARE
F86888Medicare UPIN