Bodendorfer, Karl D

Bodendorfer, Karl D is an individual health care provider with primary practice located at 1615 Sw Main Blvd , Lake City FL 32025-1108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bodendorfer, Karl D can be contacted via phone (386) 755-2785.

Contact Information

Primary practice address
1615 Sw Main Blvd Lake City FL 32025-1108
Phone: (386) 755-2785
Fax: (386) 755-1128
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME78478 Florida

Profile Details

NPI number 1205947959
LBN Legal business name Bodendorfer, Karl D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Mar 21st, 2011 - about 14 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 1205947959 NPPES
Florida MEDICAID 259120100
Florida Other P00087109
Florida Other 35612A
Florida MEDICAID 001933700
Florida MEDICAID 259120101

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