Individual
LISA S BORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12955 SHELBYVILLE RD STE 1, LOUISVILLE, KY 40243-1538
(502) 254-2223
(502) 254-2525
Mailing address
PO BOX 76879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39163
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300052598
—
IN
05
—
64103989
—
KY
01
—
K181731
MEDICARE
KY
Enumeration date
12/16/2005
Last updated
02/09/2023
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