Individual
GLENN BORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
168 COUNTRY CLUB DR, EUNICE, LA 70535-6738
(337) 457-8203
Mailing address
168 COUNTRY CLUB DR, EUNICE, LA 70535-6738
(337) 457-8203
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
017646
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1348449
—
LA
Enumeration date
06/29/2006
Last updated
05/27/2010
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