IndividualActive
Fred Bodker, MD
NPI 1417944208 · Ophthalmic Plastic and Reconstructive Surgery Physician · Overland Park, KS
Provider details
- NPI number
- 1417944208
- Entity type
- Individual
- Primary specialty
- Ophthalmic Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 04-25774 (KS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7504 Antioch Rd
Overland Park, KS 66204-2622
Phone: (913) 341-3100
Fax: (913) 341-6818
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 803861
Kansas City, MO 64180-3861
Registry dates
- Enumerated
- 2005-10-05
- Last updated
- 2025-02-03
- Certified
- 2025-02-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.