Individual
KURT O BODILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W STE 100, PROVO, UT 84604-3305
(801) 374-1268
(801) 812-5454
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
322494-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100009090
PALMETTO
—
01
—
107007621101
IHC
UT
01
—
265465
DMBA
UT
01
—
29-00038
UNITED HEALTHCARE
UT
01
—
39508
PEHP
UT
01
—
870281028BO2
EMIA
UT
01
—
QM0000009163
ALTIUS
UT
Enumeration date
07/15/2006
Last updated
04/22/2024
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