Provider Demographics
NPI:1679862023
Name:BORDADOR, APOLINAR B III (MD)
Entity Type:Individual
Prefix:
First Name:APOLINAR
Middle Name:B
Last Name:BORDADOR
Suffix:III
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 1:10001 LILE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6217
Mailing Address - Country:US
Mailing Address - Phone:501-227-8000
Mailing Address - Fax:501-221-5857
Practice Address - Street 1:10001 LILE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6217
Practice Address - Country:US
Practice Address - Phone:501-227-8000
Practice Address - Fax:501-221-5857
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115997207R00000X
ARE-7184207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR775182OtherMEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC
AR189339001Medicaid