Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brock Bodily

Individual provider Surgical Physician Assistant · NPI 1366004517

Brock Bodily is a Surgical Physician Assistant in South Jordan, Utah. Licensed in Utah. Registered with an NPI since 2019.

Licensed in
UT
In the registry since
2019

Practice location Address checks out

10623 S Redwood Rd # 101
South Jordan, UT 84095-2481
Phone: (801) 566-4242
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 11353289-8002 (UT)

Record details

NPI number1366004517
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 8, 2019
Last updated in NPPESJuly 8, 2019
Mailing address1265 N 850 E, Pleasant Grove, UT 84062-1998

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