Individual
JOHN M BODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 W MORENO ST, PENSACOLA, FL 32501-2316
(850) 469-7406
Mailing address
PO BOX 17668, PENSACOLA, FL 32522-7668
(850) 469-7406
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME94719
FL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
ME94719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009912339
—
AL
05
—
009912341
—
AL
05
—
009912342
—
AL
05
—
018335000
—
FL
01
—
35016
BCBS
FL
01
—
D514
HEALTH FIRST NETWORK
FL
Enumeration date
01/20/2006
Last updated
09/17/2021
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