Bode, Kenneth Spencer
Bode, Kenneth Spencer is an individual health care provider with primary practice located at 6301 Harris Pkwy Ste 200 , Fort Worth TX 76132-4265. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Bode, Kenneth Spencer can be contacted via phone (817) 433-3450.Contact Information
Primary practice address
6301 Harris Pkwy Ste 200
Fort Worth TX 76132-4265
Phone: (817) 433-3450
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | A122470 | California |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | MD60635856 | Washington |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | U1474 | Texas |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | U1474 | Texas |
Profile Details
| NPI number | 1710100045 |
|---|---|
| LBN Legal business name | Bode, Kenneth Spencer |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2007 |
| Last updated | May 29th, 2024 - about last year |
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 | 1710100045 | NPPES |
| Texas | Other | U1474 | STATE LICENSE |
| Texas | Other | MD60635856 | STATE LICENSE |
| Texas | Other | A122470 | STATE LICENSE |
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