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Individual

DR. DAVID J BODNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
535 MASK RD, BROOKS, GA 30205-2214
(833) 228-6889
(877) 853-0376
Mailing address
1010 N 102ND ST STE 201, OMAHA, NE 68114-2122
(833) 228-6889
(877) 853-0376

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
23913
AL
2085R0202X
Diagnostic Radiology Physician
Primary
036687
GA
2085R0202X
Diagnostic Radiology Physician
16259C
WY
2085R0202X
Diagnostic Radiology Physician
2024026884
MO
2085R0202X
Diagnostic Radiology Physician
20363
ND
2085R0202X
Diagnostic Radiology Physician
C195626
CA
2085R0202X
Diagnostic Radiology Physician
MC-185
GU

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000542264M
GA
05
009948040
AL
01
51500979
BLUE CROSS BLUE SHIELD AL
AL
01
P01064288
RAILROAD MEDICARE
GA
Enumeration date
07/01/2005
Last updated
10/24/2025
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