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General NPI Number Information
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NPI Number | 1013956051
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Entity Type | Organization
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Legal Business Name | GEORGE CARL BORST III PSC
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 1201 ST.CHRISTOPHER DRIVE
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City | ASHLAND
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State | KY
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Zip | 41101-7064
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Country | US
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Telephone | 606-324-1101
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Fax | 606-324-0404
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Provider Business Mailing Address
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Address Line | 1201 ST. CHRISTOPHER DRIVE
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City | ASHLAND
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State | KY
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Zip | 41101-7064
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Country | US
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Telephone | 606-324-1101
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Fax | 606-324-0404
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE C BORST III
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Credential | M.D.
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Telephone | 606-326-1101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 21922
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License Number State | KY
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