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General NPI Number Information
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NPI Number | 1275495947
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Entity Type | Organization
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Legal Business Name | CHARLES BORUM M.D.
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 131 JEFFERSON DAVIS BLVD STE F
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City | NATCHEZ
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State | MS
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Zip | 39120-5143
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Country | US
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Telephone | 601-442-0200
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Fax | 601-445-0210
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Provider Business Mailing Address
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Address Line | 131 JEFFERSON DAVIS BLVD STE F
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City | NATCHEZ
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State | MS
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Zip | 39120-5143
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Country | US
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Telephone | 601-442-0200
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Fax | 601-445-0210
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | THOMAS MCLEMORE
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Credential |
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Telephone | 601-422-5223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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