Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35080372 | OH |
Y | 207QS0010X | Family Doctor - Sports Medicine | 35080372 | OH |
NPI | 1073570107 |
---|---|
Provider Name | James R Borchers |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43202-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2401001 | (05) | OH |
H81892 | (02) |