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Individual

DR. LANCE HAMILTON BORUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
525 BRANSON LANDING BLVD, BRANSON, MO 65616-2052
(417) 875-3000
Mailing address
1202 RUSTIC RDG, JOPLIN, MO 64804-3679
(417) 434-2991

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0533791
KS
2085R0202X
Diagnostic Radiology Physician
Primary
2009018431
MO
2085R0202X
Diagnostic Radiology Physician
4587
OK
2085R0202X
Diagnostic Radiology Physician
E-8860
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1356320436
MO
05
200202290A
OK
05
200614030D
KS
05
204512701
MO
Enumeration date
01/17/2006
Last updated
02/02/2023
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