Individual provider · Type 1 NPI
Quinton Ty Bohannon, P.A.-C
Medical Physician Assistant · Coalgate, OK
NPI number
1003154725
Active
Practice location
108 W Ohio Ave
Coalgate, OK 74538-2827
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 2239 (OK) |
Medical Physician Assistant: Definition to come...
4 other providers at this address
- Coal County General HospitalFamily Medicine Physician Coalgate, OK NPI 1750091500
- Helton Rural Health ClinicFamily Medicine Physician Coalgate, OK NPI 1720265945
- Richard J HeltonFamily Medicine Physician Coalgate, OK NPI 1326216839
- Richard J HeltonFamily Medicine Physician Coalgate, OK NPI 1700063229
About NPI 1003154725
Quinton Ty Bohannon, P.A.-C's National Provider Identifier is 1003154725, issued on Jan 30, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Coalgate, OK. The record was last updated on Jan 30, 2013.