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:

Map and Directions

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 2 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

State	Type	Number	Issuer
All States	NPI	1639179930	NPPES
Oregon	Other	MD25128	OBME
Oregon	MEDICAID	233192	OBME

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