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General NPI Number Information
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NPI Number | 1912996448
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Entity Type | Organization
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Legal Business Name | JUEL PATE BORDERS PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 991 MARTIN LUTHER KING JR DR NW
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City | ATLANTA
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State | GA
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Zip | 30314-2947
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Country | US
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Telephone | 404-758-2192
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Fax |
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Provider Business Mailing Address
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Address Line | 991 MARTIN LUTHER KING JR DR NW
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City | ATLANTA
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State | GA
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Zip | 30314-2947
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Country | US
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Telephone | 404-758-2192
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JUEL PATE BORDERS
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Credential | M.D.
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Telephone | 404-758-2192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | GA
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