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General NPI Number Information
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NPI Number | 1023637477
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Entity Type | Individual
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Provider Name | JOSH BOHN
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Gender | Male
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 3225 PICKLE RD
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City | OREGON
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State | OH
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Zip | 43616-4026
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Country | US
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Telephone | 419-693-0465
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Fax |
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Provider Business Mailing Address
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Address Line | 542 EAST ST
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City | PEMBERVILLE
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State | OH
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Zip | 43450-9694
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Country | US
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Telephone | 419-376-7297
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | AT004377
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License Number State | OH
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