Individual
BRENT MITCHELL BODILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(801) 834-7551
Mailing address
1 JARRETT WHITE ROAD, TRIPLER ARMY MEDICAL CENTER, TAMC, HI 96859-5001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD-22451
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
06/09/2025
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