Provider Demographics
NPI:1346313947
Name:BORDERS, KAREN (MED)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:BORDERS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:BORDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:1856 THOMPSON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1663
Mailing Address - Country:US
Mailing Address - Phone:706-201-1644
Mailing Address - Fax:
Practice Address - Street 1:1856 THOMPSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1663
Practice Address - Country:US
Practice Address - Phone:706-201-1644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA311420524AMedicaid