Doctor Name: | GARY KENT BORRELL |
NPI Number: | 1952377319 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 2002-0014 |
Business Practice Address: | Unm Psychiatric Ctr 2600 Marble Ne Albuquerque, NM - 871310001 |
Business Phone Number: | 5052722800 |
Business Fax Number: | 5052728692 |
Mailing Address: | 933 Bradbury Dr Se, Suite 2222 ALBUQUERQUE |
State: | NM |
Postal Code: | 871064374 |
Phone Number: | 5052723120 |
Fax Number: | 5052728060 |
NPI Enumeration Date: | 02/27/2006 |
NPI Last Update Date: | 01/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 2002-0014 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |