Individual
DR. TRENT WADE BORDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 HOSPITAL DRVIE, SUITE A, MCKENZIE, TN 38201
(731) 352-7907
(731) 352-4459
Mailing address
205 HOSPITAL DRVIE, SUITE A, MCKENZIE, TN 38201
(731) 352-7907
(731) 352-4459
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
41767
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511635
—
TN
01
—
3380640
MEDICARE GROUP
TN
01
—
54583
AMERICAN BOARD OF RADIOLOGY CERTIFICATION
TN
Enumeration date
02/07/2007
Last updated
11/06/2009
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