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Individual

WILLIAM STEPHEN BODANSKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2419 S CLAREMONT CIR, SPRINGFIELD, MO 65804-4123
(417) 881-4859
Mailing address
13811 WOODWARD ST, OVERLAND PARK, KS 66223-1120
(913) 681-5425

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
04-23716
KS
207L00000X
Anesthesiology Physician
R7046
MO
207R00000X
Internal Medicine Physician
04-23716
KS
207R00000X
Internal Medicine Physician
Primary
R7046
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100124600B
KS
05
200657195
MO
Enumeration date
11/10/2005
Last updated
03/14/2020
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