Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Divine Tim Bonghaseh, MD

Individual provider Family Medicine Physician · NPI 1568386324

Divine Tim Bonghaseh, MD is a Family Medicine Physician in Monroe, Louisiana. Licensed in Louisiana. Registered with an NPI since 2026.

Licensed in
LA
In the registry since
2026
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4864 Jackson St
Monroe, LA 71202-6400
Phone: (318) 330-7650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 353460 (LA)

Record details

NPI number1568386324
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 5, 2026
Last updated in NPPESAugust 5, 2026
Certification dateAugust 5, 2026

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