| Dr Gregory A Bohn, MD | |
|
295 Maple St Ste 200, Tawas City, MI 48763-9352 | |
| (989) 984-3788 | |
| (989) 984-3794 |
| Full Name | Dr Gregory A Bohn |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 295 Maple St Ste 200, Tawas City, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174597702 | NPI | - | NPPES |
| 38079 | Other | BCWELLMARK | |
| IA01X1 | Other | JOHN DEERE | |
| 3091884 | Medicaid | IA | |
| 1174597702 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 036089196 (Illinois) | Secondary |
| 208600000X | Surgery | 29059 (Iowa) | Primary |
| Entity Name | Lourdes Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659861060 PECOS PAC ID: 1850642562 Enrollment ID: O20181113000853 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gregory A Bohn, MD Po Box 779, Tawas City, MI 48764-0779 Ph: (989) 362-9411 | Dr Gregory A Bohn, MD 295 Maple St Ste 200, Tawas City, MI 48763-9352 Ph: (989) 984-3788 |
Ryan Thomas Fahy, DO Surgery Medicare: Medicare Enrolled Practice Location: 295 Maple St Ste 200, Tawas City, MI 48763 Phone: 989-362-0188 Fax: 989-362-7171 | |
Surya Sankaran, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 651 M 55 E, Tawas City, MI 48763 Phone: 989-362-8681 Fax: 989-362-3321 | |
Dr. Mark A Gallagher, D.O. Surgery Medicare: Not Enrolled in Medicare Practice Location: 295 Maple St, Suite 200, Tawas City, MI 48763 Phone: 989-984-3788 |