Bohannon, Todd

Bohannon, Todd is an sole proprietor health care provider with primary practice located at 503 George Mcclain Dr , Benton KY 42025-1331. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Bohannon, Todd can be contacted via phone (270) 527-8144.

Contact Information

Primary practice address
503 George Mcclain Dr Benton KY 42025-1331
Phone: (270) 527-8144
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 33599 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 33599 Kentucky
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 33599 Kentucky

Profile Details

NPI number 1740381276
LBN Legal business name Bohannon, Todd
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2006
Last updated Jan 18th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740381276 NPPES
Kentucky MEDICAID 64005317
Kentucky Other 000000056871

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