Bookout, Mark W

Bookout, Mark W is an individual health care provider with primary practice located at 4151 Ringgold Rd , East Ridge TN 37412-2434. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Bookout, Mark W can be contacted via phone (423) 622-5165.

Contact Information

Primary practice address
4151 Ringgold Rd East Ridge TN 37412-2434
Phone: (423) 622-5165
Fax: (423) 622-5167
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 011511 Tennessee
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 025947 Georgia

Profile Details

NPI number 1356339063
LBN Legal business name Bookout, Mark W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated Dec 10th, 2012 - about 13 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 1356339063 NPPES
Georgia MEDICAID 000282125B
Georgia MEDICAID 3021453

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