Boren, Justin Luke

Boren, Justin Luke is an individual health care provider with primary practice located at 832 Westover Dr Ste 200 , Columbia TN 38401-4843. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Boren, Justin Luke can be contacted via phone (931) 830-3033.

Contact Information

Primary practice address
832 Westover Dr Ste 200 Columbia TN 38401-4843
Phone: (931) 830-3033
Fax: (931) 388-3401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1296 Tennessee

Profile Details

NPI number 1053468199
LBN Legal business name Boren, Justin Luke
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Aug 15th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053468199 NPPES
Georgia MEDICAID 874485289B
Georgia Other P00382564
Georgia MEDICAID 009941922
Georgia MEDICAID 874485289A
Georgia Other 4142242

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