Provider Demographics
NPI:1437139326
Name:BODNAR, JAMES P (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:BODNAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14275 MIDWAY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:214-932-8029
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:2620 WILHITE DRIVE
Practice Address - Street 2:SUITE 213
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3385
Practice Address - Country:US
Practice Address - Phone:317-275-8022
Practice Address - Fax:317-275-8124
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2014-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY31013207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000355714OtherBCBS
OH2389615Medicaid
KY1069838OtherPASSPORT
KY220019488OtherTRAVELERS
WV1841774-000Medicaid
KY64310139Medicaid
OH2389615Medicaid
WV1841774-000Medicaid