Provider Demographics
NPI:1699772699
Name:BOND, SHELDON J (MD)
Entity type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:J
Last Name:BOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0390
Mailing Address - Fax:502-584-5437
Practice Address - Street 1:234 E GRAY ST
Practice Address - Street 2:STE 766
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1901
Practice Address - Country:US
Practice Address - Phone:502-588-0390
Practice Address - Fax:502-584-5437
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY233702086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100330820Medicaid
KY64233703Medicaid
KY64233703Medicaid
IN100330820Medicaid