Bodkin, Kevin Scott

Bodkin, Kevin Scott is an individual health care provider with primary practice located at 4900 Broadway , Gary IN 46408-4605. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bodkin, Kevin Scott can be contacted via phone (419) 696-6000.

Contact Information

Primary practice address
4900 Broadway Gary IN 46408-4605
Fax: (419) 696-6018
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34009615 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02005742A Indiana

Profile Details

NPI number 1518123421
LBN Legal business name Bodkin, Kevin Scott
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2008
Last updated Feb 18th, 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 1518123421 NPPES
Ohio MEDICAID 2996530

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