Provider Demographics
NPI:1902890718
Name:BORKOWSKI, GAYLE J (MD)
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:J
Last Name:BORKOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:IN
Mailing Address - Zip Code:46542
Mailing Address - Country:US
Mailing Address - Phone:574-832-6246
Mailing Address - Fax:574-832-2001
Practice Address - Street 1:112 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IN
Practice Address - Zip Code:46542
Practice Address - Country:US
Practice Address - Phone:574-832-6246
Practice Address - Fax:574-832-2001
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042838207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100373280Medicaid
IN100373280Medicaid
IN223710GMedicare PIN
F88814Medicare UPIN