| Peter R. Bodnar, M.d. Pllc | |
|
6544 E Carondelet Dr Tucson AZ 85710-2117 | |
| (520) 333-7723 | |
| (520) 333-3113 |
| Full Name | Peter R. Bodnar, M.d. Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6544 E Carondelet Dr, Tucson, Arizona |
| Authorized Official Name and Position | Peter Bodnar (MANAGER) |
| Authorized Official Contact | 5203337723 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter R. Bodnar, M.d. Pllc 6544 E Carondelet Dr Tucson AZ 85710-2117 Ph: (520) 333-7723 | Peter R. Bodnar, M.d. Pllc 6544 E Carondelet Dr Tucson AZ 85710-2117 Ph: (520) 333-7723 |
| NPI Number | 1073891081 |
|---|---|
| Provider Enumeration Date | 07/25/2011 |
| Last Update Date | 01/26/2022 |
| Certification Date | 01/26/2022 |
| Medicare PECOS PAC ID | 9234302530 |
|---|---|
| Medicare Enrollment ID | O20111102000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073891081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 25515 (Arizona) | Primary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 25515 (Arizona) | Secondary |
| Provider Name | Peter R Bodnar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083762389 PECOS PAC ID: 2769566504 Enrollment ID: I20090812000713 |
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