Paul V. Bonetzky DO

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

PAUL V. BONETZKY DO

Practice address

8200 State Route 366
Russells Point, OH 43348-9670

Phone

(937) 843-5000

NPI assigned

May 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dean P Bonetzky

Title

Practice Administrator

Phone

(937) 843-5000

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• DR. PAUL V. BONETZKY INC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1770705345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 STATE ROUTE 366",
            "city": "RUSSELLS POINT",
            "state": "OH",
            "postal_code": "433489670",
            "telephone_number": "937-843-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 STATE ROUTE 366",
            "city": "RUSSELLS POINT",
            "state": "OH",
            "postal_code": "433489670",
            "telephone_number": "937-843-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL V. BONETZKY DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BONETZKY",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "937-843-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LISC.",
            "identifier": "34001524",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004228178",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0833889",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "A68388",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR. PAUL V. BONETZKY INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Urgent Care Clinic/Center in Russells Point, OH
• Providers in Russells Point, OH by specialty
• Urgent Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.