# MR. JOHN HEBER BODEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114997418
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 32434 | SC | — |
| 207WX0110X | Pediatric Ophthalmology and Strabismus Specialist Physician | 68744 | AZ | Yes |
| 208D00000X | General Practice Physician | 23537 | NE | — |

## Other

- **Enumeration date:** 01/26/2006
- **Last updated:** 10/25/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 137963 | — | AZ |