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Contact Information

JOHN A BUONOCORE, DO
3005 E STATE BLVD
FORT WAYNE, IN46805-4736
 Phone: 260-267-9498
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for JOHN A BUONOCORE · (Male)

NPI # 1992801492
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 09/15/2006
Last updated 04/01/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 02004457A
  • MI License # 5101020847
  • NY License # 182693
  • OH License # 3411255
  • MI Medicaid 1992801492
  • OH Medicaid 0103569
Hospital affiliation(s)
  • GRAND LAKE HEALTH SYSTEM - (Acute Care)
    200 SAINT CLAIR STREET
    SAINT MARYS, OH 45885
  • PAULDING COUNTY HOSPITAL - (Critical Access)
    1035 WEST WAYNE ST.
    PAULDING, OH 45879
  • VAN WERT COUNTY HOSPITAL - (Acute Care)
    1250 S WASHINGTON STREET
    VAN WERT, OH 45891
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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