Provider Demographics
NPI:1821068461
Name:BOREL, JAMES DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:BOREL
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 1:3820 W HAPPY VALLEY RD STE 141-623
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-3292
Mailing Address - Country:US
Mailing Address - Phone:602-741-9087
Mailing Address - Fax:623-580-6944
Practice Address - Street 1:3820 W HAPPY VALLEY RD STE 141-623
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-3292
Practice Address - Country:US
Practice Address - Phone:602-741-9087
Practice Address - Fax:623-580-6944
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11909207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
050074491OtherMEDICARE RAILROAD
AZ222331Medicaid
AZ222331Medicaid
050074491OtherMEDICARE RAILROAD