Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1003519919 Individual Practitioner Male Practitioner

Dr. Boden James Port , DO

General Practice • Eglin Afb, FL

Professional Overview & Biography Verified Profile Summary

Dr. Boden Port, DO is a registered healthcare professional specializing in General Practice in Eglin Afb, FL. Practice services are available at 307 BOATNER RD STE 114 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

307 Boatner Rd Ste 114

Eglin Afb, FL 325421302

Telephone 8508838600
Associated Practice Facility / Clinic
🏢 Individual Provider Facility NPI 1376890293

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Eglin Afb, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.1 Yrs
Regional Practice Density
18 Specialists

Practicing in Eglin Afb, FL (2490 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-08
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License IN 02008108A

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Lucas Petkewitz , DPT

Physical Therapist

NPI 1003228057

Doctor of Physical Therapy

Dr. Eric Weiss , MD

General Practice

NPI 1013370444

Doctor of Medicine (M.D.)

Dr. Brock Jones , MD

Military Health Care Provider

NPI 1033046024

Doctor of Medicine (M.D.)

Stephen Biggs , IDMT

Military Health Care Provider - Independent Duty Medical Technicians

NPI 1033671227
Dr. Caleb Kiesow , MD

Family Medicine

NPI 1033704226

Doctor of Medicine (M.D.)

Sandra Hoffa , LCSW

Social Worker - Clinical

NPI 1043853435

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location July 08, 2026

Registered at 307 BOATNER RD STE 114, EGLIN AFB, FL 325421302 (Tel: 8508838600)

📍
Updated Business Mailing Address July 08, 2026

Registered at 307 BOATNER RD STE 114, EGLIN AFB, FL 325421302

📍
Updated Practice Location October 24, 2024

Registered at 6900 ALDEN DR BLDG 160, FE WARREN AFB, WY 820052945 (Tel: 3077733039)

📍
Updated Business Mailing Address October 24, 2024

Registered at 6900 ALDEN DR BLDG 160, FE WARREN AFB, WY 820052945 (Tel: 3077733039)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2024

General Practice (License #02008108A in IN)

NPI Profile Active March 22, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location March 22, 2023

Registered at 1800 W CHARLESTON BLVD, LAS VEGAS, NV 891022329 (Tel: 7023832000)

📍
Updated Business Mailing Address March 22, 2023

Registered at 725 SETTLERS POND WAY, KNOXVILLE, TN 379236398 (Tel: 2082069834)

👤
Provider Name / Credentials Updated March 22, 2023

Recorded as BODEN PORT, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 22, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003519919
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 22, 2023
Last Update: July 08, 2026
Sole Proprietor: No

Mailing Address

307 Boatner Rd Ste 114

Eglin Afb, FL 325421302

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.