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General NPI Number Information
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NPI Number | 1245270404
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Entity Type | Individual
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Provider Name | JOHN J BORSA MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 4321 WASHINGTON ST STE 1400
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City | KANSAS CITY
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State | MO
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Zip | 64111-5961
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Country | US
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Telephone | 816-930-6035
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Fax | 913-234-1116
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Provider Business Mailing Address
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Address Line | PO BOX 504807
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City | SAINT LOUIS
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State | MO
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Zip | 63150-4807
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Country | US
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Telephone | 913-234-1496
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Fax | 913-234-1116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 2002012290
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2002012290
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License Number State | MO
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