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NPI Code Detail

MEDICARE: DR. TIMOTHY W BOGREN D.C.

MEDICARE:  DR. TIMOTHY W BOGREN  D.C.
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
1111N00000XChiropractor608WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001711177OTHERWVMT. ST. BCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245309004
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY W BOGREN D.C.
Provider Business Mailing Address
First Line : 332 E MAIN ST
Second Line :
City : MILTON
State : WV
Zip : 25541-1508
Country : US
Telephone Number : 304-743-1261
Fax Number : 304-743-1899
Provider Business Practice Location Address
First Line : 332 E MAIN ST
Second Line :
City : MILTON
State : WV
Zip : 25541-1508
Country : US
Telephone Number : 304-743-1261
Fax Number : 304-743-1899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 08/27/2008

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Directions to “ DR. TIMOTHY W BOGREN D.C.” Practice Location

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