Individual
BRYAN BORDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
546 HUNTERS GLN, MADISONVILLE, KY 42431-8688
(270) 824-9630
(270) 824-9630
Mailing address
546 HUNTERS GLN, MADISONVILLE, KY 42431-8688
(270) 824-9630
(270) 824-9630
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
1005409168
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111564
ANTHEM BLUE CROSS
KY
05
—
86054012
—
KY
Enumeration date
02/07/2007
Last updated
07/09/2007
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