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NPI Code Detail

MEDICARE: MR. ROBERT C BORDEN PA C

MEDICARE: MR. ROBERT C BORDEN PA C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA-456AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14645995OTHERFLAETNA
259074070OTHERFLBSAL

General Provider Information

NPI Number : 1538142641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT C BORDEN PA C
Provider Business Mailing Address
First Line : 6701 AIRPORT BLVD
Second Line : SUITE B 114
City : MOBILE
State : AL
Zip : 36608-6705
Country : US
Telephone Number : 251-633-5155
Fax Number : 251-633-5125
Provider Business Practice Location Address
First Line : 6701 AIRPORT BLVD
Second Line : SUITE B 114
City : MOBILE
State : AL
Zip : 36608-6705
Country : US
Telephone Number : 251-633-5155
Fax Number : 251-633-5125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 07/08/2007

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Directions to “ MR. ROBERT C BORDEN PA C” Practice Location

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