Individual
TIMOTHY DEAN BOHLENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 S. BURMA AVE., GILLETTE, WY 82716-3246
(307) 688-9255
(307) 688-7920
Mailing address
PO BOX 3011, GILLETTE, WY 82717-3011
(307) 688-2690
(307) 688-1486
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8888A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01277557
—
CO
Enumeration date
09/05/2006
Last updated
12/29/2020
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