Individual
JUSTIN WAYNE BORDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
700 US 1 HWY STE 100, YOUNGSVILLE, NC 27596-7873
(919) 562-2340
(919) 562-2315
Mailing address
3762 DURHAM RD A, ROXBORO, NC 27573-2741
(336) 330-0400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04057
NC
363AM0700X
Medical Physician Assistant
0010-04057
NC
Other
Enumeration date
01/30/2013
Last updated
05/18/2023
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