Boden, John M
Boden, John M is an individual health care provider with primary practice located at 1000 W Moreno St , Pensacola FL 32501-2316. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Boden, John M can be contacted via phone (850) 469-7406.Contact Information
Primary practice address
1000 W Moreno St
Pensacola FL 32501-2316
Phone: (850) 469-7406
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME94719 | Florida |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207RH0002X | ME94719 | Florida |
Profile Details
| NPI number | 1417937707 |
|---|---|
| LBN Legal business name | Boden, John M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Sep 17th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417937707 | NPPES |
| Florida | MEDICAID | 018335000 | |
| Florida | MEDICAID | 009912339 | |
| Florida | MEDICAID | 009912341 | |
| Florida | MEDICAID | 009912342 | |
| Florida | Other | D514 | |
| Florida | Other | 35016 |
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