Individual
DR. BARRY STEPHEN BORDENAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
321 OVERHILL DR, LAKE CHARLES, LA 70605-6527
(337) 474-8886
Mailing address
321 OVERHILL DR, LAKE CHARLES, LA 70605-6527
(337) 474-8886
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
13559
LA
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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