Individual
WILLIAM BODINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4000
Mailing address
1040 SIERRA DR, STE 400, GREENWOOD, IN 46143-7241
(317) 865-8988
(317) 859-8590
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001661A
IN
Other
Enumeration date
06/25/2014
Last updated
06/28/2016
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