Individual provider · NPI-1

Dr. William B Bohannon, DO

Family Medicine · Lagrange, GA

NPI number1467439133
StatusActive
Last updated in NPPESMar 21, 2025

Details

NPI
1467439133
Entity type
Individual (NPI-1)
Name
Dr. William B Bohannon
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
Dec 23, 2005
Certification date
Mar 21, 2025
Last updated
Mar 21, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine92783GAYes
207Q00000X Family MedicineD0818AL

Practice location

1497 Lafayette Pkwy
Lagrange, GA 30241-2552

Phone 706-803-8190

Mailing address

1497 Lafayette Pkwy
Lagrange, GA 30241-2552

Phone 706-803-8190

Other practice locations

400 E 10th St
Anniston, AL 36207-4716

Phone 256-741-6464 · Fax 256-231-8676

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