Individual
DR. LUIS CAMPOS-DE-LA-BORBOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1265 UNION AVE, SUITE 184, MEMPHIS, TN 38104-3415
(901) 516-0929
(901) 516-8993
Mailing address
PO BOX 1000, DEPT # 457, MEMPHIS, TN 38148-0001
(901) 516-0929
(901) 516-8993
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
44107
TN
208600000X
Surgery Physician
D0060736
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00873097
—
MS
05
—
170500001
—
AR
01
—
4355465
BCBS
TN
05
—
Q002436
—
TN
Enumeration date
07/26/2006
Last updated
08/04/2014
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