DR. CHARLES D BORUM (NPI# 1417042979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417042979 |
| Entity Type | Individual |
| Full Name | DR. CHARLES D BORUM |
| Credential | M.D. |
| Practice Address |
131 Jefferson Davis Blvd. Suite F Natchez MS 39120 |
| Practice Telephone | 6014420200 |
| Practice Fax Number | 6014450210 |
| Mailing Telephone | 6014420200 |
| Mailing Fax Number | 6014450210 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 10244 | MS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00015972 | 05 |
| Street Address |
131 JEFFERSON DAVIS BLVD. SUITE F |
| City | NATCHEZ |
| State | MS |
| Zip Code | 39120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558903518 | Rosa L. Newman | Foster Care Agency | 722 North Rankin St, Natchez, MS 39120 | 2019-10-11 |
| 1114572625 | Tiffany Cassandra Lockhart | Counselor | 60 Roux Road, Natchez, MS 39120 | 2019-08-02 |
| 1164918728 | We Care Express LLC | Non-emergency Medical Transport (VAN) | 137 Greystone Pl, Natchez, MS 39120 | 2018-07-06 |
| 1053841585 | Tyler Lee Huls | Specialist/Technologist | 48 Sgt Prentiss Drive, Natchez, MS 39120 | 2017-06-18 |
| 1336594985 | Nkechinyere Christina Nwoko | Podiatrist | 46 Sgt Prentiss Dr Ste 201b, Natchez, MS 39120 | 2016-05-02 |
| 1073983433 | Lillie Christine Hauer | Case Manager/Care Coordinator | 9 Roux 61, Suite C, Natchez, MS 39120 | 2015-09-29 |
| 1760818017 | Miss-lou Dental LLC | Dentist | 110 Highway 61 South, Natchez, MS 39120 | 2013-09-18 |
| 1922344902 | Bluebonnet Dental Care Natchez | Dentist | 101 Highway 61 South, Natchez, MS 39120 | 2012-12-20 |
| 1265781033 | Hal Sheldon Edwards | Pharmacist | 285 Sgt Prentiss Drive, Natchez, MS 39120 | 2012-09-07 |
| 1790031607 | Catherine Misita | Social Worker | 113 N Union St, Natchez, MS 39120 | 2012-07-29 |
| Find all providers in zip 39120 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164892634 | Jefferson Comprehensive Health Center, Inc. | Specialist | 170 Sgt Prentiss Dr, Natchez, MS 39120-4737 | 2015-09-28 |
| 1285990622 | Deshaun Antonio Jackson | Specialist | 1406 Westwood Rd, Natchez, MS 39120-5055 | 2012-04-10 |
| 1275862609 | Advanced Management, LLC | Specialist | 14 Sara Ln, Natchez, MS 39120-8602 | 2009-12-14 |
| 1912115528 | Natchez Oncology Center | Specialist | 133 Jefferson Davis Blvd, Natchez, MS 39120-5103 | 2007-05-18 |
| 1295879203 | Natchez Regional Medical Center | Specialist | 54 Seargent S. Prentiss Dr, Natchez, MS 39121-1488 | 2007-02-16 |
| 1720014939 | Leslie E England | Specialist | 151 Jefferson Davis Blvd, Suite C, Natchez, MS 39120-5140 | 2006-06-23 |
| 1194767806 | Vikramaditya Dulam | Specialist | 140 Jefferson Davis Blvd, Natchez, MS 39120-5104 | 2006-06-10 |
| 1801845136 | Geoffrey J Flattmann | Specialist | 142 Jeff Davis Blvd, Suite A, Natchez, MS 39120-5104 | 2006-05-05 |
| 1225441504 | Dr. Sherman Medical Clinic | Specialist | 55 Sgt Prentiss Dr, Suite 104, Natchez, MS 39120-4782 | 2014-06-04 |
| 1104177823 | Elizabeth R. Marks | Specialist | 55 Sgt Prentiss Dr, Suite 8, Natchez, MS 39120-4782 | 2012-09-20 |
| Find all providers in NATCHEZ | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.