Thomas Francis Boduch, M.D.

General Practice Physician · Kingston, TN

Individual Active NPI

NPI number 1770588741

Practice location

314 E Spring St
Kingston, TN 37763-2839
Phone
(865) 376-1212
Fax
(865) 376-0010

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NPI record

NPI
1770588741
Entity type
Individual (Type 1)
Enumeration date
June 16, 2005
Last updated
January 10, 2012
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X MD0000014330 TN
Family Medicine Physician 207Q00000X 14330 TN

Mailing address

PO Box 1030
Kingston, TN 37763-1030
Phone
(865) 376-1212
Fax
(865) 376-0010

About Dr. Boduch

Thomas Francis Boduch, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 314 E Spring St, Kingston, TN 37763-2839. The NPI number 1770588741 was assigned on June 16, 2005 and the record was last updated on January 10, 2012.

Dr. Boduch lists 2 licenses in the registry: #MD0000014330 (TN) for General Practice Physician; #14330 (TN) for Family Medicine Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Thomas Francis Boduch, M.D.?

The NPI number is 1770588741.

What is the phone number of Dr. Boduch?

The phone number listed for the practice location is (865) 376-1212.

Where is Dr. Boduch located?

314 E Spring St, Kingston, TN 37763-2839.

What is the taxonomy code for Dr. Boduch?

The primary taxonomy code is 208D00000X – General Practice Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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