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Individual

DR. JOHN STEVEN BOHANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
20 HARTFORD ST, HOULTON, ME 04730-1891
(207) 532-2900
Mailing address
20 HARTFORD ST, HOULTON, ME 04730
(207) 532-2900

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD19119
ME
207Q00000X
Family Medicine Physician
Primary
ME0045018
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
048103300
FL
01
ME45018
STATE MEDICAL LICENSE
FL
Enumeration date
11/17/2006
Last updated
05/24/2017
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