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Individual

KYLE BOHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3950 S COUNTRY CLUB RD STE 130, TUCSON, AZ 85714-2203
(520) 670-3909
Mailing address
3950 S COUNTRY CLUB RD, TUCSON, AZ 85714-2099
(520) 724-7770
(520) 309-2560

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
010766
AZ
207Q00000X
Family Medicine Physician
036144438
IL
207Q00000X
Family Medicine Physician
69257
WI
207Q00000X
Family Medicine Physician
A-2495-21
NM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457730855
WI
Enumeration date
05/19/2015
Last updated
02/19/2024
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