Provider Demographics
NPI:1083671002
Name:BOHNEY, JAMES P (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:BOHNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N. MERIDIAN ST.
Mailing Address - Street 2:STE. 500, PROVIDER ENROLLMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:IU HEALTH PHYSICIANS BUILDING
Practice Address - Street 2:820 SAMUEL MOORE PARKWAY
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46258-1794
Practice Address - Country:US
Practice Address - Phone:317-483-5000
Practice Address - Fax:317-483-5050
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042495A208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000086759OtherANTHEM
IN100410830Medicaid
INM400065032Medicare PIN
INF71716Medicare UPIN
IN000000086759OtherANTHEM
IN715530SSSMedicare PIN