DWAYNE PATRICK BONVILLAIN (NPI# 1538723564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538723564 |
| Entity Type | Individual |
| Full Name | DWAYNE PATRICK BONVILLAIN |
| Credential | DPT |
| Practice Address |
3615 Hospital St Ste B Pascagoula MS 39581-4112 |
| Practice Telephone | 2287621602 |
| Mailing Telephone | 2287621602 |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
PT4504 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT4504 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3615 HOSPITAL ST STE B |
| City | PASCAGOULA |
| State | MS |
| Zip Code | 39581-4112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760945448 | Jacquelyn B Ellison | Nurse Practitioner | 4105 Hospital Road, Ste 103, Pascagoula, MS 39581 | 2019-04-10 |
| 1104346816 | Jennifer Ngoc Bui | Dentist | 4001 Denny Ave Suite 1, Pascagoula, MS 39581 | 2017-06-23 |
| 1528486289 | Thomas Stallworth | Nurse Practitioner | 4105 Hospital St Ste 104, Pascagoula, MS 39581 | 2014-03-31 |
| 1487919957 | Candace Noel Pendowski | Nurse Practitioner | 4211 Hospital St Suite 208, Pascagoula, MS 39581 | 2012-07-10 |
| 1649548892 | Kim M. Tumminello | Nurse Practitioner | 4253 Denny Avenue, Pascagoula, MS 39581 | 2011-12-02 |
| 1649547860 | Abrian Norell Flowers | Physical Therapist | 3537 Denny Avenue, Suite 115, Pascagoula, MS 39581 | 2011-11-17 |
| 1164724118 | Coast To Coast Rehab LLC | Rehabilitation Practitioner | 3537 Denny Ave, Suite 115, Pascagoula, MS 39581 | 2010-11-24 |
| 1740500958 | Joshua Eric Tucker | Physical Medicine & Rehabilitation | 4105 Hospital St Ste 112b, Pascagoula, MS 39581 | 2010-06-10 |
| 1720164916 | Vernon W Doster | Family Medicine | 3616 Hospital Street, Suite D, Pascagoula, MS 39581 | 2006-10-31 |
| 1841387727 | David Bruce Allen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4300 Hospital Rd, Suite 105, Pascagoula, MS 39581 | 2006-10-10 |
| Find all providers in zip 39581 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245754092 | Ryan Steven Clayton | Physical Therapist | 90a Clark St, Tupelo, MS 38804-4812 | 2017-08-02 |
| 1467835686 | James Fehrenbacher | Physical Therapist | 702 Treeline Dr, Brandon, MS 39042-4036 | 2015-07-07 |
| 1790109080 | Richard Dymond Jr. | Physical Therapist | 2781 Ct Switzer Rd., Biloxi, MS 39531 | 2014-02-07 |
| 1932362324 | Family Physical Therapy of South Ms LLC | Physical Therapist | 100-a La Rosa Rd, Long Beach, MS 39560 | 2008-07-07 |
| 1205914009 | Joe Gregg Jones | Physical Therapist | 1702 Highway 11 N Ste B, Picayune, MS 39466-2016 | 2006-11-01 |
| 1619051315 | Vincent E Cheshire | Physical Therapist | 1702 Highway 11 N, Suite B, Picayune, MS 39466-2016 | 2006-10-25 |
| 1811514599 | Steven Cialone | Physical Therapist | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2020-06-29 |
| 1427523901 | Robyn Mackenzie Taylor | Physical Therapist | 206b Oxford Rd, New Albany, MS 38652-3115 | 2018-10-10 |
| 1225403579 | Jodie Orr | Physical Therapist | 401 Southcrest Cir, Southaven, MS 38671-6726 | 2015-12-10 |
| 1821474438 | John Horlock | Physical Therapist | 1325 E Fortification St, Po Drawer 16870, Jackson, MS 39202-2442 | 2015-08-05 |
| Find all providers with the same taxonomy | ||||
| City | PASCAGOULA |
| Zip Code | 39581 |
Please comment or provide details below to improve the information on DWAYNE PATRICK BONVILLAIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.