Organization
BODIFORD EYE INSTITUTE, PA
Active
Organization
BODIFORD EYE INSTITUTE, PA
Active
Other names
Bodiford Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L BODIFORD M.D. (OWNER)
(479) 649-7018
Entity
Organization
Contact information
Practice address
9001 JENNY LIND RD, FORT SMITH, AR 72908-8629
(479) 649-7018
(479) 649-7024
Mailing address
9001 JENNY LIND RD, FORT SMITH, AR 72908-8629
(479) 649-7018
(479) 649-7024
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MC-1402
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728040A
—
OK
01
—
1163920001
DMERC
AR
01
—
180029680
RR MEDICARE
OK
01
—
180034141
RAILROAD MEDICARE
AR
01
—
432291569-001
BLUE CROSS
OK
01
—
5B988
BLUE CROSS
AR
Enumeration date
11/09/2006
Last updated
04/01/2013
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