Boden James Port, DO is a medicare enrolled "General Practice" physician in Fe Warren Afb, Wyoming. His current practice location is
6900 Alden Dr Bldg 160, Fe Warren Afb, Wyoming. You can reach out to his office (for appointments etc.) via phone at
(307) 773-3039.
Boden James Port is licensed to practice in Indiana (license number 02008108A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003519919.
Physician's Profile
Full Name | Boden James Port |
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Gender | Male |
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Speciality | General Practice |
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Location | 6900 Alden Dr Bldg 160, Fe Warren Afb, Wyoming |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1003519919
- Provider Enumeration Date: 03/22/2023
- Last Update Date: 10/24/2024
Medicare PECOS Information:
- PECOS PAC ID: 4486016508
- Enrollment ID: I20230821003701
Medical Identifiers
Medical identifiers for Boden James Port such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1003519919 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 02008108A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Boden James Port is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Boden James Port, DO 6900 Alden Dr Bldg 160, Fe Warren Afb, WY 82005-2945 Ph: (307) 773-3039 | Boden James Port, DO 6900 Alden Dr Bldg 160, Fe Warren Afb, WY 82005-2945 Ph: (307) 773-3039 |
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