Bode, Timothy D

Bode, Timothy D is an individual health care provider with primary practice located at 124 S Memorial Dr , Prattville AL 36067-3619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bode, Timothy D can be contacted via phone (334) 613-3680.

Contact Information

Primary practice address
124 S Memorial Dr Prattville AL 36067-3619
Phone: (334) 613-3680
Fax: (334) 613-3685
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 21352 Alabama

Profile Details

NPI number 1235108333
LBN Legal business name Bode, Timothy D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated May 19th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235108333 NPPES
Other 051098078 BLUE CROSS BLUE SHIELD
MEDICAID 009935640 BLUE CROSS BLUE SHIELD

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