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NPI Code Detail

MEDICARE: DR. BARRY A BOHLEN M.D.

MEDICARE: DR. BARRY A BOHLEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician70456MN
2207X00000XOrthopaedic Surgery Physician21904NE

General Provider Information

NPI Number : 1710928130
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARRY A BOHLEN M.D.
Provider Business Mailing Address
First Line : 520 E 10TH ST
Second Line :
City : SUPERIOR
State : NE
Zip : 68978-1225
Country : US
Telephone Number : 402-462-2139
Fax Number : 402-462-2381
Provider Business Practice Location Address
First Line : 2207 OSBORNE DR W
Second Line : SUITE 100
City : HASTINGS
State : NE
Zip : 68901-9112
Country : US
Telephone Number : 402-462-2139
Fax Number : 402-462-2381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 11/11/2021

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Directions to “ DR. BARRY A BOHLEN M.D.” Practice Location

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