Provider Demographics
NPI:1023191178
Name:BORGMAN, PAUL GREGORY JR (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GREGORY
Last Name:BORGMAN
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:COMMUNITY HOSPICE 4266 SUNBEAM RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MORRIS CTR. 580 WEST 8TH ST.
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-1652
Practice Address - Fax:904-244-1656
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 0005933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG30978Medicare UPIN