Individual
DR. GREGORY JAY BORDELON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1542 TULANE AVE, STE 659, NEW ORLEANS, LA 70112-2865
(504) 568-2315
Mailing address
5575 JACQUELYN CT, NEW ORLEANS, LA 70124-1046
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD.207954
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2149920
—
LA
Enumeration date
03/18/2011
Last updated
04/17/2017
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