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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427039973 NPPES
Missouri MEDICAID 200657195
Missouri MEDICAID 100124600B

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