Organization
JOSEPHINE S BOHANNON
Active
Other names
Midlothian Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPHINE S BOHANNON MD (PRESIDENT OWNER)
(804) 378-3048
Entity
Organization
Contact information
Practice address
2306 ROBIOUS STATION CIRCLE, MIDLOTHIAN, VA 23113
(804) 378-3048
(804) 379-5167
Mailing address
PO BOX 247, MIDLOTHIAN, VA 23113
(804) 378-5010
(804) 378-3264
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0982798
ANTHEM BS GROUP
VA
01
—
DE4573
RAILROAD MEDICARE GROUP
—
Enumeration date
09/16/2006
Last updated
06/27/2008
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