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General NPI Number Information
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NPI Number | 1376518746
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Entity Type | Individual
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Provider Name | ERIC EUGENE BOROFSKY MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 08/06/2015
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Provider Practice Location Address
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Address Line | 5300 S HIGHWAY 95 SUITE D
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City | FORT MOHAVE
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State | AZ
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Zip | 86426-9251
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Country | US
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Telephone | 928-788-3609
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Fax | 928-788-3607
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Provider Business Mailing Address
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Address Line | 5300 S HIGHWAY 95 SUITE D
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City | FORT MOHAVE
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State | AZ
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Zip | 86426-9251
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Country | US
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Telephone | 928-788-3609
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Fax | 928-788-3607
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | EB042101
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License Number State | MI
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