Individual provider · NPI-1

Dr. Timothy D Bode, M.D.

Family Medicine · Prattville, AL

NPI number1235108333
StatusActive
Last updated in NPPESMay 19, 2008

Details

NPI
1235108333
Entity type
Individual (NPI-1)
Name
Dr. Timothy D Bode
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Mar 14, 2006
Last updated
May 19, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine21352ALYes

Practice location

124 S Memorial Dr
Prattville, AL 36067-3619

Phone 334-613-3680 · Fax 334-613-3685

Mailing address

4371 Narrow Lane Rd
Suite 100
Montgomery, AL 36116-2971

Phone 334-613-3680 · Fax 334-613-3685

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