Provider Demographics
NPI:1487639068
Name:BORDERS, GUY THOMPSON (MD)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:THOMPSON
Last Name:BORDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 W HOSPITAL DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7802
Mailing Address - Country:US
Mailing Address - Phone:520-547-0433
Mailing Address - Fax:520-547-0435
Practice Address - Street 1:1980 W HOSPITAL DR
Practice Address - Street 2:SUITE 204
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7802
Practice Address - Country:US
Practice Address - Phone:520-547-0433
Practice Address - Fax:520-547-0435
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ267332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00396974OtherRXR MEDICARE
PA1017201250001Medicaid
OH2740145Medicaid
AZ68902819Medicaid
ID807538000Medicaid
OH2740145Medicaid
AZ68902819Medicaid