Borden, Evetta Lavern
Borden, Evetta Lavern is an individual health care provider with primary practice located at 510 E Stoner Ave , Shreveport LA 71101-4243. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as her primary health care specialty. Borden, Evetta Lavern can be contacted via phone (912) 977-0584.Contact Information
Primary practice address
510 E Stoner Ave
Shreveport LA 71101-4243
Phone: (912) 977-0584
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | POD000770 | Georgia |
Profile Details
| NPI number | 1215946702 |
|---|---|
| LBN Legal business name | Borden, Evetta Lavern |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 5th, 2006 |
| Last updated | Sep 1st, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215946702 | NPPES |
| Georgia | MEDICAID | 00719804B |
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