Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Primary Care of Bonne Terre LLC

Organization General Practice Physician · NPI 1962883751

Primary Care of Bonne Terre LLC is a General Practice Physician in Bonne Terre, Missouri. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

527 Benham St
Bonne Terre, MO 63628-1205
Phone: (573) 358-9119
Fax: (573) 358-9489
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1962883751
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Ninichuck — Owner · (573) 358-9119
Other names Primary Care Of Bonne Terre
NPI enumeratedJune 17, 2015
Last updated in NPPESNovember 23, 2015
Mailing address527 Benham St, Bonne Terre, MO 63628-1205

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