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Individual

MR. JOHN HEBER BODEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-1000
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
137963
AZ
Enumeration date
01/26/2006
Last updated
10/25/2023
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