Individual
MR. TIMOTHY PATRICK BOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5700 E PIMA STREET, SUITE B, TUCSON, AZ 85712-2805
(520) 324-1922
(520) 324-1088
Mailing address
5700 E PIMA STREET, SUITE B, TUCSON, AZ 85712-5601
(520) 382-2819
(520) 382-2832
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP1294
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
569212
AHCCCS
AZ
05
—
569212-02
—
AZ
Enumeration date
10/19/2006
Last updated
07/08/2007
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