Individual
MICHAEL JUDE BORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 N STATE ST, SUITE 300, JACKSON, MS 39202-2001
(601) 981-4091
(601) 981-5039
Mailing address
1200 N STATE ST, SUITE 300, JACKSON, MS 39202-2001
(601) 981-4091
(601) 981-5039
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
12475
MS
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
12475
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114935
—
MS
01
—
180021390
RAILROAD MEDICARE
MS
Enumeration date
10/04/2006
Last updated
04/14/2017
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