Basic Information
| Provider Information | |||||||||
| NPI: | 1487701272 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOHL | ||||||||
| FirstName: | JAIME | ||||||||
| MiddleName: | LYNNE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 91734 | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232911734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043586100 | ||||||||
| FaxNumber: | 8043427619 | ||||||||
| Practice Location | |||||||||
| Address1: | 9109 STONY POINT DR | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232351979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043278001 | ||||||||
| FaxNumber: | 8043278002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 01/11/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208C00000X | 0101261479 | VA | Y | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
No ID Information.