Organization
BOHLER FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SCOTT BOHLKE MD (PRESIDENT)
(912) 842-2101
Entity
Organization
Contact information
Practice address
128 NORTH PARKER AVE, BROOKLET, GA 30415
(912) 842-2101
(921) 842-2103
Mailing address
PO BOX 487, BROOKLET, GA 30415-0487
(912) 842-2101
(921) 842-2103
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00593557D
—
GA
05
—
085002953G
—
GA
05
—
648007516A
—
GA
Enumeration date
01/18/2007
Last updated
01/08/2015
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