Provider Demographics
NPI:1265483317
Name:BOHLMAN, HAROLD RAY III (OD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:RAY
Last Name:BOHLMAN
Suffix:III
Gender:M
Credentials:OD
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Mailing Address - Street 1:PO BOX 4000
Mailing Address - Street 2:EYE CLINIC (112E)
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684-4000
Mailing Address - Country:US
Mailing Address - Phone:423-979-3510
Mailing Address - Fax:423-979-3530
Practice Address - Street 1:JAMES H. QUILLEN VA MEDICAL CENTER
Practice Address - Street 2:EYE CLINIC (112E)
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-979-3510
Practice Address - Fax:423-979-3530
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IA2027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist