Bodner, Bradley T

Bodner, Bradley T is an individual health care provider with primary practice located at 2800 Westhill Dr Suite 200, Wausau WI 54401-3771. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Bodner, Bradley T can be contacted via phone (715) 843-1000.

Contact Information

Primary practice address
2800 Westhill Dr Suite 200 Wausau WI 54401-3771
Phone: (715) 843-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1312-023 Wisconsin

Profile Details

NPI number 1093767808
LBN Legal business name Bodner, Bradley T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Dec 15th, 2021 - 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 1093767808 NPPES
Wisconsin MEDICAID 41923000

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