Stephen Odell Boehning

Primary specialty

SpecialistTaxonomy code 174400000X

License

20-4025903 Issued in AZ

Practice address

2340 W Bell Rd Ste 112
Phoenix, AZ 85023-3206

Phone

(602) 298-1822

Fax

(602) 298-1823

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1538212261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 W BELL RD STE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850233206",
            "telephone_number": "602-298-1822",
            "fax_number": "602-298-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 W BELL RD STE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850233206",
            "telephone_number": "602-298-1822",
            "fax_number": "602-298-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHNING",
        "first_name": "STEPHEN",
        "middle_name": "ODELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "20-4025903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark D Boesen, PHARM.D.

• Specialist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.