Provider Demographics
NPI:1477612257
Name:BORGESS PULMONARY MEDICINE
Entity Type:Organization
Organization Name:BORGESS PULMONARY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-345-1161
Mailing Address - Street 1:1535 GULL RD
Mailing Address - Street 2:STE 130
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1650
Mailing Address - Country:US
Mailing Address - Phone:269-345-1161
Mailing Address - Fax:269-345-8076
Practice Address - Street 1:1535 GULL RD
Practice Address - Street 2:STE 130
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1650
Practice Address - Country:US
Practice Address - Phone:269-345-1161
Practice Address - Fax:269-345-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty