Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
QUINTON TY BOHANNON, P.A.-C
ActiveQUINTON TY BOHANNON, P.A.-C is a Medical Physician Assistant healthcare provider located in COALGATE, Oklahoma. NPI 1003154725 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · COALGATE, OK
Registration Details
- NPI Number
- 1003154725
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 30, 2013 (13.536029944383 yrs)
- Last Updated
- Jan 30, 2013
- License
-
2239 (OK)
Practice Information
- Address
-
108 W OHIO AVECOALGATE, OK, 745382827Browse OK providers · Browse ZIP 74538
- Phone
- 5809272334
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.