Dr. Bo Tyler Headlam is a Portsmouth, Ohio based physiatrist who is specialized in Pain Management (PM&R). Active license number of Dr. Bo Tyler Headlam is 286498 in New York.
Dr. Bo Tyler Headlam provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Complete Profile:
Dr. Bo Tyler Headlam speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Pain Management (PM&R)
Credentials:
M.D.
Gender:
Male
Practice Address:
1735 27th St, Waller Building, Suite 302, Portsmouth, Ohio, 45662-2677
Phone:
740-356-6808
Fax:
740-356-6826
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1619939246
NPI Enumeration Date:
06 Apr, 2006
NPI Last Update On:
19 Feb, 2025
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Bo Tyler Headlam are as mentioned below.
License Number
Specialization
State
Status
286498
New York
Primary
25588
Pain Management (PM&R)
Nebraska
Secondary
036115263
Pain Management (PM&R)
Illinois
Secondary
25588
Pain Medicine
Nebraska
Secondary
25588
Pain Medicine
Nebraska
Secondary
036115263
Pain Medicine
Illinois
Secondary
35120229
Pain Management (PM&R)
Ohio
Secondary
35120229
Pain Medicine
Ohio
Secondary
35120229
Pain Medicine
Ohio
Secondary
286498
Pain Management (PM&R)
New York
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Bo Tyler Headlam such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
4632039
Other
Illinois
BCBS GROUP
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
68 S Service Rd, Suite 100 Melville, New York
Zip:
11747-2354
Phone Number:
631-465-2094
Fax Number:
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Patients can reach Dr. Bo Tyler Headlam at 1735 27th St, Waller Building, Suite 302, Portsmouth, Ohio or can call to book an appointment on 740-356-6808. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 July, 2025.