Provider Demographics
NPI:1699880468
Name:BOHLENDER, DAVID L (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:BOHLENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:629 S. PLUMMER AVE.
Mailing Address - Street 2:P. O. BOX 426
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-0426
Mailing Address - Country:US
Mailing Address - Phone:620-431-4000
Mailing Address - Fax:620-431-7556
Practice Address - Street 1:301 N MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3444
Practice Address - Country:US
Practice Address - Phone:316-282-9614
Practice Address - Fax:316-284-9602
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0424113207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100165940CMedicaid
F39141Medicare UPIN