Bodach, Kirk Jon

Bodach, Kirk Jon is an individual health care provider with primary practice located at 615 N Michigan St Fl 1 , South Bend IN 46601-1033. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bodach, Kirk Jon can be contacted via phone (574) 647-3050.

Contact Information

Primary practice address
615 N Michigan St Fl 1 South Bend IN 46601-1033
Phone: (574) 647-3050
Fax: (574) 647-1094
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01065817A Indiana

Profile Details

NPI number 1306044003
LBN Legal business name Bodach, Kirk Jon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2007
Last updated Mar 30th, 2021 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1306044003 NPPES
Indiana Other M400050759 MEDICARE PTAN
Indiana Other P01050896 MEDICARE PTAN
Indiana MEDICAID 200986910 MEDICARE PTAN
Indiana Other 000000720320 MEDICARE PTAN

Popular Providers