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Individual

STEPHANIE ANN BODEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
215 CENTRAL AVE, LOUISVILLE, KY 40208-1449
(502) 588-4521
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
59249
KY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036.163992
IL

Other

Enumeration date
04/02/2018
Last updated
07/26/2024
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