Individual
TED BORODOFSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1903 BROADWAY ST, PADUCAH, KY 42001-7105
(270) 442-1671
(270) 442-7307
Mailing address
1903 BROADWAY ST, PADUCAH, KY 42001-7105
(270) 442-1671
(270) 442-7307
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18831
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044965
ANTHEM BCBS
—
05
—
0470669210
—
IL
05
—
64188311
—
KY
Enumeration date
03/02/2006
Last updated
10/25/2007
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