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General NPI Number Information
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NPI Number | 1578568978
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Entity Type | Individual
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Provider Name | JOHN M BORMES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 310 8TH AVE NW
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City | ABERDEEN
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State | SD
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Zip | 57401-2365
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Country | US
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Telephone | 605-226-2108
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Fax | 605-229-7460
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Provider Business Mailing Address
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Address Line | 310 8TH AVE NW
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City | ABERDEEN
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State | SD
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Zip | 57401-2365
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Country | US
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Telephone | 605-226-2108
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Fax | 605-229-7460
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 7056
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 3849
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License Number State | SD
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