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NPI Code Detail

MEDICARE: MICHAEL JUDE BORNE M.D.

MEDICARE: MICHAEL JUDE BORNE M.D.
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
1207W00000XOphthalmology Physician12475MS
2207WX0107XRetina Specialist (Ophthalmology) Physician12475MS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2180021390OTHERMSRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588750178
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JUDE BORNE M.D.
Provider Business Mailing Address
First Line : 1200 N STATE ST
Second Line : SUITE 300
City : JACKSON
State : MS
Zip : 39202-2001
Country : US
Telephone Number : 601-981-4091
Fax Number : 601-981-5039
Provider Business Practice Location Address
First Line : 1200 N STATE ST
Second Line : SUITE 300
City : JACKSON
State : MS
Zip : 39202-2001
Country : US
Telephone Number : 601-981-4091
Fax Number : 601-981-5039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 04/14/2017

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Directions to “ MICHAEL JUDE BORNE M.D.” Practice Location

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