Individual
ROY BORS-KOEFOED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
6266 POPLAR AVE, MEMPHIS, TN 38119-4713
(901) 682-2595
(901) 682-2549
Mailing address
6266 POPLAR AVE, MEMPHIS, TN 38119-4713
(901) 682-2595
(901) 682-2549
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
35990
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125606
—
MS
01
—
154425331
TRICARE
TN
05
—
156721001
—
AR
05
—
3871735
—
TN
01
—
4067158
BCBST
TN
01
—
4315297
CIGNA
TN
01
—
4451436
AETNA HMO
TN
01
—
99201
BCBS AR
AR
Enumeration date
08/12/2006
Last updated
12/12/2011
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