NPI 1467430249 · live from the CMS NPI Registry
John Bodkin, DO
Emergency Medicine in Charleston, WV. National Provider Identifier 1467430249, active.
NPI record
| NPI | 1467430249 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Emergency Medicine 207P00000X |
| Practice location | 3200 Maccorkle Ave Se, Charleston, WV 25304 |
| Practice phone | 304-388-4170 |
| Mailing address | 4750 Hempstead Station Dr, Kettering, OH 45429 |
| Enumerated | January 3, 2006 |
| Last updated | December 19, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | 1975 (WV) |
| Emergency Medicine primary | 207P00000X | DO3973 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.