Provider Demographics
NPI:1831203181
Name:BOHL, JENNIFER REBECCA (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:REBECCA
Last Name:BOHL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1001 LAKESIDE AVE E
Mailing Address - Street 2:#1200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1158
Mailing Address - Country:US
Mailing Address - Phone:216-479-5541
Mailing Address - Fax:216-479-5554
Practice Address - Street 1:10 SEVERANCE CIR
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1533
Practice Address - Country:US
Practice Address - Phone:216-621-5600
Practice Address - Fax:216-297-2678
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2008-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-087264207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology