Individual
EVETTA LAVERN BORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(912) 977-0584
Mailing address
614 WESTMORELAND DR, HINESVILLE, GA 31313-4419
(912) 977-0584
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
POD000770
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00719804B
—
GA
Enumeration date
08/05/2006
Last updated
09/01/2023
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