Beverly A Bodman in Colorado Springs - Physician Assistant
Beverly A Bodman - NPI 1912984162
Beverly A Bodman is a Physician Assistant in Colorado Springs, Colorado. Beverly A Bodman practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Beverly A Bodman is 1912984162. The last update date is 2007-07-08.
Beverly A Bodman's current location address is 340 Printers Pkwy, Colorado Springs, Colorado. You can contact this provider via phone number 7196306440 and fax number 7192286609. The mailing address for Beverly A Bodman is 340 Printers Pkwy, Colorado Springs, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Beverly A Bodman |
|---|---|
| Address | 340 Printers Pkwy, Colorado Springs, Colorado |
| Phone Number | 7196306440 |
| Fax Number | 7192286609 |
| Sole Proprietor | X |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1912984162 |
|---|---|
| Provider Enumeration Date | 2005-12-29 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 340 Printers Pkwy |
|---|---|
| City | Colorado Springs |
| State | Colorado (CO) |
| Post Code | 809103190 |
| Phone Number | 7196306440 |
| Fax Number | 7192286609 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 1164 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8372764 | CO | -- |
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Where is the Beverly A Bodman located?
The Beverly A Bodman is located at 340 Printers Pkwy, Colorado Springs, CO 809103190.
Could you please provide the complete physical location address of Beverly A Bodman?
The Beverly A Bodman is physically situated at 340 Printers Pkwy, in the city of Colorado Springs, state of CO, with the postal code 809103190.
What is the Beverly A Bodman's specialty and taxonomy code?
The Beverly A Bodman's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
When was the Beverly A Bodman's 1912984162 issued?
The Beverly A Bodman's 1912984162 was issued on 2005-12-29.
On what date did the Centers for Medicare & Medicaid Services issue the 1912984162 to Beverly A Bodman?
The Beverly A Bodman received its 1912984162 assignment from the Centers for Medicare & Medicaid Services on 2005-12-29.