Bollom, Timothy S
Bollom, Timothy S is an individual health care provider with primary practice located at 2200 Ne Neff Rd Ste 200, Bend OR 97701-4283. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Bollom, Timothy S can be contacted via phone (541) 382-3344.Contact Information
Primary practice address
2200 Ne Neff Rd Ste 200
Bend OR 97701-4283
Phone: (541) 382-3344
Fax: (541) 382-1681
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | MD25128 | Oregon |
Profile Details
| NPI number | 1639179930 |
|---|---|
| LBN Legal business name | Bollom, Timothy S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | May 9th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639179930 | NPPES |
| Oregon | Other | MD25128 | OBME |
| Oregon | MEDICAID | 233192 | OBME |
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