Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Bonne Terre Health Clinic LLC

Organization Family Medicine Physician · NPI 1104071935

Bonne Terre Health Clinic LLC provides Family Medicine Physician services in Bonne Terre, Missouri. Licensed in Missouri. Registered with an NPI since 2008.

Licensed in
MO
In the registry since
2008
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

55 Nesbit Dr
Bonne Terre, MO 63628-1353 Not confirmed with CMS for 17 years — call before visiting
Phone: (573) 358-3343
Fax: (573) 358-5458
Show map & directions

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

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X · Licence 102387 (MO)
Family Medicine Physician Taxonomy 207Q00000X · Licence 102387 (MO)

Record details

NPI number1104071935
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Ninichuck — Member · (573) 358-3343
NPI enumeratedNovember 20, 2008
Last updated in NPPESSeptember 24, 2009
Mailing address55 Nesbit Dr, Bonne Terre, MO 63628-1353

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