Individual
DR. MARK LEONARD BORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1310 24TH AVE S, TENNESSEE VALLEY HEALTH SYSTEM, NASHVILLE, TN 37212-2637
(615) 873-7550
(615) 873-8431
Mailing address
432 PRESTWICK CT, NASHVILLE, TN 37205-5016
(615) 873-7550
(615) 873-8431
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
MD011034
TN
2085R0202X
Diagnostic Radiology Physician
Primary
MD011034
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3023997
MEDICARE MEDICAID/TENNCARE
TN
05
—
3023997
—
TN
Enumeration date
05/23/2006
Last updated
05/19/2011
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