Doctor Name: | DR. WILLIAM TODD BOHANNON |
NPI Number: | 1023077864 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | J8466 |
Business Practice Address: | 2401 S 31st St Temple, TX - 765080001 |
Business Phone Number: | 2547242111 |
Business Fax Number: | |
Mailing Address: | Po Box 847408, DALLAS |
State: | TX |
Postal Code: | 752847408 |
Phone Number: | 2547242111 |
Fax Number: | |
NPI Enumeration Date: | 03/21/2006 |
NPI Last Update Date: | 07/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | J8466 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |