Individual
DR. JOHN WILLIAM BODFORD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5959 PARK AVE, MEMPHIS, TN 38119-5200
(901) 765-1000
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
56172
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2014
Last updated
10/16/2018
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