Provider Demographics
NPI:1942466073
Name:BODIFORD, BRANDY M (DO)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:M
Last Name:BODIFORD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:M
Other - Last Name:O'NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1245 WESTGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2151
Mailing Address - Country:US
Mailing Address - Phone:334-793-9595
Mailing Address - Fax:
Practice Address - Street 1:1245 WESTGATE PKWY
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2151
Practice Address - Country:US
Practice Address - Phone:334-793-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4676207Q00000X
AL1422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine