BOHLER FAMILY PRACTICE PC NPI 1811049679

NPI Information

NPI: 1811049679
Provider Name: BOHLER FAMILY PRACTICE PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D0696733

Address:
128 NORTH PARKER AVE
BROOKLET, GA
ZIP 30415
Phone: (912) 842-2101
Get Directions

BOHLER FAMILY PRACTICE PC is a primary care clinic center in Brooklet, GA. BOHLER FAMILY PRACTICE PC NPI is 1811049679. The provider is registered as an organization entity type.

The provider's business location address is:

128 NORTH PARKER AVE
BROOKLET, GA
ZIP 30415
Phone: (912) 842-2101
Fax: (921) 842-2103

The provider's authorized official is William Scott Bohlke .
The authorized official title is President and has the following contact phone number (912) 842-2101.

The CLIA number assigned to this NPI record is 11D0696733 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 1/8/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	08BBQDV	MEDICARE PIN	GEORGIA
2	00593557D	MEDICAID	GEORGIA
3	F76385	MEDICARE UPIN	GEORGIA
4	085002953G	MEDICAID	GEORGIA
5	08BDQBK	MEDICARE PIN	GEORGIA
6	H86888	MEDICARE UPIN	GEORGIA
7	648007516A	MEDICAID	GEORGIA
8	GRP3740	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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