Bodanske, William Stephen
Bodanske, William Stephen is an sole proprietor health care provider with primary practice located at 2419 S Claremont Cir , Springfield MO 65804-4123. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Bodanske, William Stephen can be contacted via phone (417) 881-4859.Contact Information
Primary practice address
2419 S Claremont Cir
Springfield MO 65804-4123
Phone: (417) 881-4859
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | R7046 | Missouri |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 04-23716 | Kansas |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | R7046 | Missouri |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 04-23716 | Kansas |
Profile Details
| NPI number | 1427039973 |
|---|---|
| LBN Legal business name | Bodanske, William Stephen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Mar 14th, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427039973 | NPPES |
| Missouri | MEDICAID | 200657195 | |
| Missouri | MEDICAID | 100124600B |
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