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Individual

DR. KEVIN JOHN BORDELON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4239 HIGHWAY 1192, SUITE 200, MARKSVILLE, LA 71351-4771
(318) 253-8600
(318) 253-8654
Mailing address
4239 HIGHWAY 1192, SUITE 200, MARKSVILLE, LA 71351-4771
(318) 253-8600
(318) 253-8654

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
023281
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1541729
LA
Enumeration date
05/30/2005
Last updated
01/04/2011
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