EVETTA LAVERN BORDEN DPM NPI 1215946702

NPI Information

NPI: 1215946702
Provider Name: EVETTA LAVERN BORDEN, DPM
Classification: Podiatrist - 213ES0131X
Entity Type: Individual

Specialization: Foot Surgery

PECOS Registration: Yes

Address:
510 E STONER AVE
SHREVEPORT, LA
ZIP 71101
Phone: (912) 977-0584
Get Directions

Evetta Lavern Borden, DPM is a foot surgery podiatrist in Shreveport, LA. Evetta Lavern Borden, DPM NPI is 1215946702. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

510 E STONER AVE
SHREVEPORT, LA
ZIP 71101-243
Phone: (912) 977-0584

The NPI 1215946702 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/5/2006 and was last updated on 9/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0131X	Podiatrist	Foot Surgery	POD000770	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00719804B	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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