Headlam, Bo Tyler

Headlam, Bo Tyler is an individual health care provider with primary practice located at 1735 27Th St Waller Building, Suite 302, Portsmouth OH 45662-2677. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Headlam, Bo Tyler can be contacted via phone (740) 356-6808.

Contact Information

Primary practice address
1735 27Th St Waller Building, Suite 302 Portsmouth OH 45662-2677
Phone: (740) 356-6808
Fax: (740) 356-6826
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 25588 Nebraska
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 036115263 Illinois
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 25588 Nebraska
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 25588 Nebraska
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 036115263 Illinois
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 35120229 Ohio
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 35120229 Ohio
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 35120229 Ohio
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 286498 New York
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 286498 New York

Profile Details

NPI number 1619939246
LBN Legal business name Headlam, Bo Tyler
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Feb 10th, 2017 - about 7 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 1619939246 NPPES
Illinois Other 4632039 BCBS GROUP

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