Provider Demographics
NPI:1760686539
Name:BORCHARD, KEVIN SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:SCOTT
Last Name:BORCHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2019
Mailing Address - Country:US
Mailing Address - Phone:970-826-2400
Mailing Address - Fax:970-826-2429
Practice Address - Street 1:785 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2019
Practice Address - Country:US
Practice Address - Phone:970-826-2400
Practice Address - Fax:970-826-2429
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45733207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43257356Medicaid