Provider Demographics
NPI:1770763427
Name:BORDELON, CURRY JOSEPH III (PNP-AC)
Entity type:Individual
Prefix:MR
First Name:CURRY
Middle Name:JOSEPH
Last Name:BORDELON
Suffix:III
Gender:M
Credentials:PNP-AC
Other - Prefix:
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Mailing Address - Street 1:6687 GUNSTOCK LN
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-1436
Mailing Address - Country:US
Mailing Address - Phone:678-362-6478
Mailing Address - Fax:
Practice Address - Street 1:1968 PEACHTREE RD NW
Practice Address - Street 2:PIEDMONT HOSPITAL, NICU
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-605-3568
Practice Address - Fax:404-367-3565
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-10
Last Update Date:2008-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN157261363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal