Provider Demographics
NPI:1972685279
Name:BORDELON, JOSEPH YVES JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:YVES
Last Name:BORDELON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 HOSPITAL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6552
Mailing Address - Country:US
Mailing Address - Phone:337-948-7090
Mailing Address - Fax:337-942-8108
Practice Address - Street 1:1200 HOSPITAL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6552
Practice Address - Country:US
Practice Address - Phone:337-948-7090
Practice Address - Fax:337-942-8108
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2015-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA012611207RS0012X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1309419Medicaid
LA012611OtherSTATE MEDICAL LICENSE
LA50435Medicare ID - Type Unspecified
LA1309419Medicaid