Quinton Ty Bohannon, PA-C is a medicare enrolled "Physician Assistant - Medical" in Coalgate, Oklahoma. He graduated from nursing school in 2012 and has 12 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Aspire Health Management Llc and his current practice location is
108 W Ohio Ave, Coalgate, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(580) 927-2334.
Quinton Ty Bohannon is licensed to practice in Oklahoma (license number 2239) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1003154725.
Provider's Profile
| Full Name | Quinton Ty Bohannon |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 12 Years |
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| Location | 108 W Ohio Ave, Coalgate, Oklahoma |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Quinton Ty Bohannon graduated from nursing school in 2012
NPI Data:
- NPI Number: 1003154725
- Provider Enumeration Date: 01/30/2013
- Last Update Date: 01/30/2013
Medicare PECOS Information:
- PECOS PAC ID: 3678717980
- Enrollment ID: I20130926000065
Medical Identifiers
Medical identifiers for Quinton Ty Bohannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003154725 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AM0700X | Physician Assistant - Medical | 2239 (Oklahoma) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Aspire Health Management Llc | 6305235565 | 4 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Quinton Ty Bohannon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Quinton Ty Bohannon, PA-C
108 W Ohio Ave,
Coalgate, OK 74538-2827
Ph: (580) 927-2334 | Quinton Ty Bohannon, PA-C
108 W Ohio Ave,
Coalgate, OK 74538-2827
Ph: (580) 927-2334 |
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