Provider Demographics
NPI:1194822445
Name:BOHIGIAN, R. KIRK (MD)
Entity Type:Individual
Prefix:
First Name:R.
Middle Name:KIRK
Last Name:BOHIGIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16 HAYDEN AVENUE
Mailing Address - Street 2:LAHEY CLINIC
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7929
Mailing Address - Country:US
Mailing Address - Phone:781-372-7195
Mailing Address - Fax:781-372-7149
Practice Address - Street 1:16 HAYDEN AVENUE
Practice Address - Street 2:LAHEY CLINIC
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-7929
Practice Address - Country:US
Practice Address - Phone:781-372-7195
Practice Address - Fax:781-372-7149
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA55647207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110042789AMedicaid
MAJ0517201Medicare PIN
MAA58238Medicare UPIN