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General NPI Number Information
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NPI Number | 1174548093
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Entity Type | Organization
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Legal Business Name | JOHN E. BODDEN, M.D.P.A.
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/25/2014
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Provider Practice Location Address
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Address Line | 440 E SAMPLE RD SUITE #106
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4444
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Country | US
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Telephone | 954-943-3303
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Fax | 954-785-3200
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Provider Business Mailing Address
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Address Line | 440 E SAMPLE RD SUITE #106
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4444
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Country | US
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Telephone | 954-943-3303
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Fax | 954-785-3200
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Authorized Official
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Title or Position | ORTHOPAEDIC SURGEON
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Name | DR. JOHN E BODDEN
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Credential | M.D.
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Telephone | 954-943-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME0021447
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License Number State | FL
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