MEDICARE: DR. AMY K BODART DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO 3599	FL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	2236	TX

General Provider Information

NPI Number	:	1447592464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY K BODART DPM

Provider Business Mailing Address
First Line	:	1225 E CLIFF DR STE 2A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4700
Country	:	US
Telephone Number	:	915-598-3338
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 E CLIFF DR STE 2A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4700
Country	:	US
Telephone Number	:	915-598-3333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	03/30/2023

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Directions to “ DR. AMY K BODART DPM” Practice Location

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